Abstract
Helicobacter pylori (H. pylori) infection is on the rise as a cause of immune thrombocytopenia (ITP). It has been suggested that platelet recovery can be achieved following successful microbial eradication, although, the exact pathophysiology has yet to be fully elucidated. This study evaluated the long-term effects of H. pylori eradication monotherapy on platelet count recovery in patients with ITP. H. pylori eradication was analysed in 61 ITP patients. Patients who maintained a complete response (CR) for more than six months were classified as sustained responders (SR). The prevalence of H. pylori infection was 54.3% (75/138), and the success rate of eradication with first-line therapy was 71.4% (35/49). Patients who had achieved a CR at 2 months maintained a higher platelet count thereafter. At 1 year following eradication, platelet counts had increased 2.78 times in the eradicated group, 1.36 times in the sustained infection group, and 1.33 times in the no infection group compared with the baseline (P = 0.016).
Highlights
Helicobacter pylori (H. pylori) infection is on the rise as a cause of immune thrombocytopenia (ITP)
There are few large-scale prospective studies designed for the degree of platelet recovery based on the results of H. pylori eradication in ITP patients, the timing of the treatment response has yet to be established as seen in steroid or IVIG treatments[11]
We calculated the eradication rate with first-line treatment; among the 75 patients diagnosed as H. pylori infection, 49 patients were treated with first-line regimen for eradication
Summary
Helicobacter pylori (H. pylori) infection is on the rise as a cause of immune thrombocytopenia (ITP). Based on recent systematic reviews, more than half of patients have successfully recovered platelet counts following H. pylori eradication treatment, and the clinical course was most pronounced in geographic regions with high baseline H. pylori infection rates[6,7]. Based on these findings, the Maastricht V guidelines strongly recommend the treatment of H. pylori eradication for chronic ITP; likewise, the Korean Helicobacter Treatment Guidelines, revised in 2013, recommend treatment of H. pylori in ITP patients[8,9]. The aim of this study was to clarify the long-term effect of H. pylori eradication monotherapy on the platelet count recovery in patients with ITP
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