[Elevated level of Helicobacter pylori antibodies in Henoch-Schonlein purpura].
BACKGROUND
Henoch-Schönlein purpura is a non-thrombocytopenic haemorrhagic syndrome characterized by deposition of immunocomplexes in the wall of the arterioles, capillaries and venules, involving the skin, joints, gastrointestinal mucosa, and glomeruli. Several causal factors could be responsible for its evaluation, however the exact exciting agent have not been identified yet. The Helicobacter pylori infection is suggested as a possible cause of Henoch-Schönlein purpura by some authors too (Gasparini and al: Eur J Gastroenterol, 1997, 9, 231-233).


OBJECTIVE
Between 1995-2000 11 adult patients (64 +/- 10 year) suffering from Henoch-Schönlein purpura were admitted in our department taking particular care over detecting Helicobacter pylori infection.


METHODS
Patients were classified as having either Henoch-Schönlein purpura in acute phase (5) or in remission phase (6). Each patient underwent panendoscopy with 2-2 biopsies being taken from the corpus, antral and duodenal mucosa. It was investigated the type of inflammation and the existence of Helicobacter pylori. The authors studied laboratory and immunological profiles of all the patients. Previously non of the patients got eradication therapy.


RESULTS
The serological investigations revealed Helicobacter pylori infection in ten investigated patients. Patients in the acute phase had significantly higher level of anti H. pylori IgG (86 +/- 32 versus 32.5 +/- 23 U/ml) (p < 0.05) compared to remission. Anti H. pylori IgA were elevated with significant difference in remission phase (3.09 +/- 1.78 versus 1.96 +/- 0.58 ratio) (p < 00.5). TNF-alpha level were significantly increased in acute phase (58.8 +/- 18 versus 27.3 +/- 5 pg/ml) (p < 0.001). Serum IgA level were also significantly higher in acute phase (5.44 +/- 1.04 versus 3.49 +/- 1.14) (p < 0.05). Anti Streptococcus DN-ase B were higher only in two patients. ANCA were negative in the all patients.


CONCLUSIONS
According to authors findings the results suggest that seropositivity for Helicobacter pylori may be a risk factor for Henoch-Schönlein purpura. The causal role of Helicobacter pylori in the developing of Helicobacter pylori induced extraintestinal manifestations is equivocal however, it can not be ruled out with absolute certainty. To better understanding of this entity further clinical and experimental examinations have to be performed.
Novák
János
J
Békés Megyei Pándy Kálmán Kórház, III. Belgyógyászati Osztály-Gasztroenterológia, Gyula.
Csiki
Zoltán
Z
Sebesi
Judit
J
Takáts
Alajos
A
Demeter
Pál
P
Sipka
Sándor
S
D000208:Acute Disease; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood* / Q000302:isolation & purification*; D001706:Biopsy; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D004386:Duodenum; D016145:Endoscopy, Digestive System; D005260:Female; D005753:Gastric Mucosa / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D011695:IgA Vasculitis / Q000276:immunology / Q000382:microbiology*; D007070:Immunoglobulin A / Q000097:blood; D007413:Intestinal Mucosa / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein