Does Helicobater pylori initiate or perpetuate immune thrombocytopenic purpura?
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.
Michel
Marc
M
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
Cooper
Nichola
N
Jean
Christelle
C
Frissora
Christine
C
Bussel
James B
JB
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
D000900:Anti-Bacterial Agents