Impact of Helicobacter pylori Eradication Therapy on Platelet Counts in Patients With Chronic Idiopathic Thrombocytopenic Purpura.

Mohamadreza Amiri

doi:10.5539/gjhs.v8n7p35

Abstract

This study was a before and after clinical evaluation of Helicobacter pylori eradication on platelet counts in a group of 23 patients with chronic Idiopathic (Autoimmune) thrombocytopenic purpura (CITP). H. pylori infection was identified in patients by a 13C-urea breath test and confirmed by an H. pylori stool antigen test. Eradication was conducted in patients testing positive. Infected (n = 10) and uninfected (n = 13) patient groups did not differ with respect to age, gender, history of previous splenectomy, treatment with anti-D, current treatment with corticosteroids, or initial platelet counts. H. pylori eradication was successful in eight infected CITP patients, with two patients not responsive to treatment. Compared to the uninfected group, patients in the infected group who responded to eradication therapy had significantly increased platelet counts after six months (56.2 ± 22.2 vs. 233 ± 85.6 ×103 million cells/L; P < 0.01), whereas platelet counts in the non-responding patients and uninfected group did not differ after this period of time. H. pylori eradication promotes significant platelet count improvement in patients with CITP. Thus, all patients with CITP should be tested and treated for H. pylori infections.

Highlights

Idiopathic (Autoimmune) thrombocytopenic purpura is a condition in which the immune system destroys platelets, impairing normal blood clotting
Compared to the uninfected group, patients in the infected group who responded to eradication therapy had significantly increased platelet counts after six months (56.2 ± 22.2 vs. 233 ± 85.6 ×103 million cells/L; P < 0.01), whereas platelet counts in the non-responding patients and uninfected group did not differ after this period of time
Twenty-four (14 male and 10 female) patients were diagnosed with chronic Idiopathic (Autoimmune) thrombocytopenic purpura (CITP) and were under treatment in the Pediatric Hematology Clinic during 2010–2011

Summary

Introduction

Idiopathic (Autoimmune) thrombocytopenic purpura is a condition in which the immune system destroys platelets, impairing normal blood clotting. The condition typically occurs one to four weeks after exposure to common viral infections and is associated with petechiae and purpura symptoms in 1–4-year-old children who were previously healthy (Paul Scott, Montgomery, Blanchard, & Czinn, 2007). Helicobacter pylori is a gram-negative bacterium that represents one of the most common infections in children and affects approximately half of the world population (Ciancarelli et al, 2002). It is most commonly transmitted by fecal-oral or oral-oral routes (Lanzkowsky, 2005), and causes chronic inflammation in the stomach, the amount of which varies by strain and from host to host. Platelet counts is often increased in CITP patients treated for Helicbacter pylori infection (Paul Scott et al, 2007)

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