title: Does Helicobater pylori initiate or perpetuate immune thrombocytopenic purpura?
abstract: To determine the prevalence of Helicobacter pylori (H pylori) infection in North American patients with immune thrombocytopenic purpura (ITP) and the effect of H pylori eradication on the platelet count, a prospective study was performed. Seventy-four patients aged 10 years and older (mean age of 41 years) with chronic ITP and a platelet count below 60 x 10(9)/L were enrolled. H pylori infection was found in 22% of patients by means of a breath test and could not be predicted by gastrointestinal symptoms. H pylori-positive patients (52.5 years of age) were older than H pylori-negative patients (38.5 years of age; P =.0035). Fifteen of the 16 H pylori-positive patients were treated and the bacteria was eradicated in 14 (93%). After 3 months, a significant response (platelet count > 50 x 10(9)/L and doubling the initial count) was observed in only one patient. After a median follow-up of 11.5 months, none of the 14 patients had responded. Ten H pylori-negative patients treated with the same regimen also did not increase their platelet counts. In conclusion, unlike several previous reports, this study does not implicate H pylori in the pathogenesis of ITP since the prevalence of H pylori infection was low and eradication of H pylori did not positively influence the course of the ITP.
authors.affiliation: New York Presbyterian Hospital, Department of Pediatrics, Division of Pediatric Hematology/Oncology, Weill Medical College of Cornell University, 525 East 68th St, New York, NY 10021, USA. drmarcmichel@hotmail.com
authors.forename: Marc
authors.initials: M
authors.lastname: Michel
authors.forename: Nichola
authors.initials: N
authors.lastname: Cooper
authors.forename: Christelle
authors.initials: C
authors.lastname: Jean
authors.forename: Christine
authors.initials: C
authors.lastname: Frissora
authors.forename: James B
authors.initials: JB
authors.lastname: Bussel
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000209:etiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents