title: [Current status of treatment for patients with idiopathic thrombocytopenic purpura in the Hokkaido area (evaluation of Helicobacter pylori eradication)].
abstract: Treatment guidelines for patients with idiopathic thrombocytopenic purpura (ITP) have been changed recently due to the clinical application of Helicobacter pylori (H. pylori) eradication but there has been no detailed multi-center analysis of the hematological effects of H. pylori eradication. The Clinical Hematology Forum consists of 11 large hematological departments and divisions in the Hokkaido area. We sent questionnaires to these 11 hematological departments and divisions in March 2003 to obtain information on current treatment strategies for patients with ITP and hematological results after the eradication of H. pylori. Questionnaires were returned by 9 (81.8%) of the 11 departments. Doctors in all hospitals had experience in diagnosis and treatment of H. pylori infection. Diagnostic examinations for H. pylori infection were performed in 54.3% of the registered cases. H. pylori infection was detected in 68.1% of the examined cases, and eradication treatment was performed in 87.7% of H. pylori-positive patients. H. pylori was eradicated in 52 (83.9%) of the 62 patients in whom the results of treatment could be evaluated. Among the patients whose platelet counts were less than 10.0 x 10(4)/microl, platelet recovery was observed in 48.8% of cases with successful eradication, a percentage similar to previously reported percentages in Japan. There was no prognostic factor to predict good responders before eradication treatment. Since the side effects of eradication treatment, including gastrointestinal symptoms and skin eruptions, were not serious, this method might become a front-line treatment for patients with ITP. Patient selection for eradication as an up-front treatment, analysis of the pathophysiology of platelet recovery after eradication and long-term effects should be investigated to make new treatment guidelines for newly diagnosed patients with ITP.
authors.affiliation: Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hashino
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ota
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Junji
authors.initials: J
authors.lastname: Tanaka
authors.forename: Manabu
authors.initials: M
authors.lastname: Musashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Miyake
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kurosawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Shiroshita
authors.forename: Teiichi
authors.initials: T
authors.lastname: Hirano
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Irie
authors.forename: Masanobu
authors.initials: M
authors.lastname: Morioka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Noto
authors.forename: Hajime
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Sachiko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tsugumichi
authors.initials: T
authors.lastname: Kawamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kakinoki
authors.forename: Naoki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kasai
authors.forename: Takaki
authors.initials: T
authors.lastname: Oya
authors.forename: Mari
authors.initials: M
authors.lastname: Hirano
authors.forename: Masanori
authors.initials: M
authors.lastname: Tanaka
authors.forename: Nozomi
authors.initials: N
authors.lastname: Fujimoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Imamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires