Helicobacter pylori eradication can induce platelet recovery in chronic idiopathic thrombocytopenic purpura.
We prospectively investigated the prevalence of Helicobacter pylori (H. pylori) infection in a cohort of 54 adult Serbian patients with chronic idiopathic thrombocytopenic purpura (ITP), and examined the effects of its eradication on their platelet counts. H. pylori infection was diagnosed in 39/54 (72.2%) patients, using the 14C-urea breath test; and was significantly higher than in the healthy Serbian population (55% P < 0.05). H. pylori-positive patients were significantly older than H. pylori-negative patients (P = 0.006), though there were no significant differences regarding gender, disease duration, mean platelet counts, previous therapies and spleen status between H. pylori-positive and H. pylori-negative patients. Successful eradication was confirmed in 23/30 (77%) treated patients. Stable platelet recovery was registered in 6/23 eradicated patients (26.1%) and maintained for 18 months. Complete and partial remissions were achieved in two and four patients, respectively, including one highly refractory patient. A significant mean platelet recovery was seen 6 months after successful H. pylori eradication in the group of 23 patients (P < 0.05). No platelet recovery was registered in either H. pylori-negative (n = 15), untreated H. pylori-positive patients (n = 9) or H. pylori-positive non-eradicated patients (n = 7). Even though the pathogenetic mechanisms of H. pylori-induced thrombocytopenia remain obscure, the results of this small prospective study support the use of H. pylori eradication as an effective non-immunosuppressive treatment for chronic ITP.
Suvajdzić
Nada
N
Institute of Hematology, Clinical Center of Serbia, Serbia and Montenegro. nvukovic@Eunet.yu
Stanković
Boris
B
Artiko
Vera
V
Cvejić
Tanja
T
Bulat
Vladislava
V
Bakrac
Milena
M
Colović
Milica
M
Obradović
Vladimir
V
Atkinson
Henry Dushan E
HD
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001792:Blood Platelets; D001944:Breath Tests; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications; D020127:Recovery of Function / Q000187:drug effects*; D012074:Remission Induction
D000900:Anti-Bacterial Agents