[Helicobacter pylori eradication based upon a drug sensitivity test effectively increased platelet count in a patient with refractory idiopathic thrombocytopenic purpura].
We report on case of a 52-year-old male with refractory idiopathic thrombocytopenic purpura. Treatment with prednisolone, vincristine, azathioprine, colchicine, danazol, diaphenylsulfone, and splenectomy were tried but all were ineffective and platelet counts mostly stayed below 5,000/microliter. We finally tried eradicating Helicobacter pylori (HP) with the standard combination of amoxicillin (1,500 mg), clarithromycin (400 mg), and lansoprazole (60 mg) for 7 days, but it failed. We therefore gave the patient a second eradication therapy based upon a drug sensitivity test using HP obtained from his gastric mucosa. According to the drug sensitivity test, we treated him with minocycline (200 mg), levofloxacin (600 mg), and lansoprazole (60 mg) for 7 days. The platelet counts increased gradually and reached to 30,000/microliter after the eradication, and the patient was spared extended hospitalization.
Asaumi
Noboru
N
First Mizushima Hospital.
Masuda
Kouzou
K
Yoshida
Chikamasa
C
Kiguchi
Toru
T
Niiya
Masami
M
Niiya
Kenji
K
Tanimoto
Mitsune
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D064704:Levofloxacin; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage; D015242:Ofloxacin / Q000008:administration & dosage; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D064747:Lansoprazole; D064704:Levofloxacin; D015242:Ofloxacin; D008911:Minocycline; D009853:Omeprazole