title: Helicobacter pylori eradication in the management of patients with idiopathic thrombocytopenic purpura.
abstract: OBJECTIVE
  To investigate the relation between Helicobacter pylori infection and the clinical features of idiopathic thrombocytopenic purpura (ITP), and to examine the effects of H. pylori eradication on platelet counts.
  
  
  METHODS
  A(13)C urea breath test for H. pylori infection was performed in a cohort of 137 consecutive patients with ITP. Patients who tested positive received standard eradication therapy if their platelet count was <50 x 10(9)/L or if they had symptoms of dyspepsia.
  
  
  RESULTS
  H. pylori infection was detected in 64 patients (47%), and was not associated with dyspepsia or other clinical or laboratory features. Eradication therapy was successfully administered to 52 patients. Platelet responses were observed in 17 (33%) of these patients, which lasted for more than 1 year in 11 patients. Duration of ITP was shorter among responders than nonresponders. Only one response was observed among patients with severe thrombocytopenia (platelet count <30 x 10(9)/L).
  
  
  CONCLUSIONS
  The prevalence of H. pylori infection in patients with ITP is similar to that found in the general population. Infection is not associated with distinctive features of the disease. H. pylori eradication may improve the platelet counts in adults in whom the ITP is of recent onset and in those with less severe degrees of thrombocytopenia, but was not effective in patients with chronic severe ITP.
authors.affiliation: Department of Medical Sciences, Regina Apostolorum Hospital, Via S. Francesco 50, 00041 Albano Laziale, Italy. roberto.stasi@uniroma2.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Stasi
authors.forename: Zaccaria
authors.initials: Z
authors.lastname: Rossi
authors.forename: Elisa
authors.initials: E
authors.lastname: Stipa
authors.forename: Sergio
authors.initials: S
authors.lastname: Amadori
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Newland
authors.forename: Drew
authors.initials: D
authors.lastname: Provan
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage; D004415:Dyspepsia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D014508:Urea / Q000032:analysis
chemical_list: D007074:Immunoglobulin G; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin; D009853:Omeprazole