title: [Successful platelet recovery after the second eradication of Helicobacter pylori with metronidazole in two patients with chronic idiopathic thrombocytopenic purpura].
abstract: There are many reports on the efficacy of Helicobacter pylori (H. pylori) eradication therapy in patients with H. pylori-positive chronic idiopathic thrombocytopenic purpura (ITP). We administrated metronidazole (MNZ), amoxicillin (AMPC), and a proton-pump inhibitor (PPI) as the second eradication therapy for two patients who failed in the first eradication therapy consisting of PPI, AMPC, and clarithromycin (CAM). Successful eradication and the rapid recovery of platelet counts within one month were achieved in both patients. Recently, H. pylori eradication is considered as the first-line therapy for H. pylori-positive chronic ITP patients. In Japan, the PPI + AMPC + CAM regimen is recognized as the standard eradication therapy for H. pylori. However, the PPI + AMPC + MNZ regimen is also useful for eradication and should be tried as the re-treatment regimen after failure of the first-line CAM-containing regimen.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Tokuyama Central Hospital.
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hatao
authors.forename: Koji
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D017291:Clarithromycin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage*; D010976:Platelet Count; D054328:Proton Pump Inhibitors; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin