title: Association of Helicobacter pylori with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome after bone marrow transplantation.
abstract: Thrombotic microangiopathy (TMA) has attracted attention as a complication of bone marrow transplantation (BMT). The association of Helicobacter pylori (H. pylori) with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (TTP/HUS) after BMT was studied. Among 74 consecutive patients undergoing transplantation, six developed TTP/HUS (the TTP/HUS group) and 68 did not (controls). These six patients were compared with the other 68 patients to investigate differences of the IL-12 and 8 levels, H. pylori and various clinical characteristics. The patients who developed TTP/HUS seemed not apparently different from those who did not in background characteristics, except that they had a significantly higher H. pylori-positive rate (p < 0.05). In the TTP/HUS group, however, the levels of interleukin-12 and interleukin-8 increased significantly during the leukocyte recovery after BMT and at the onset of TTP/HUS, respectively, to 45.8 +/- 57.6 pg/mL and 274.8 +/- 65.9 pg/mL (p < 0.05 for both), when compared with their levels of 5.0 pg/mL in the control group. Thus, H. pylori may play a role in the pathogenesis of TTP/HUS after BMT, with cytokines (interleukin-8 and interleukin-12) also being involved.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Department of Medicine, Hyogo College of Medicine, Hyogo, Japan. htakatsu@hyo-med.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takatsuka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wakae
authors.forename: Akinari
authors.initials: A
authors.lastname: Toda
authors.forename: Hisayuki
authors.initials: H
authors.lastname: Itoi
authors.forename: Masaya
authors.initials: M
authors.lastname: Okada
authors.forename: Mahito
authors.initials: M
authors.lastname: Misawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hara
authors.forename: Eizo
authors.initials: E
authors.lastname: Kakishita
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology; D015169:Colony Count, Microbial; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology / Q000502:physiology*; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology*; D006801:Humans; D018664:Interleukin-12 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007962:Leukocytes / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning
chemical_list: D016209:Interleukin-8; D018664:Interleukin-12