title: Platelet activation in Helicobacter pylori-associated idiopathic thrombocytopenic purpura: eradication reduces platelet activation but seldom improves platelet counts.
abstract: BACKGROUND
  It has been suggested that Helicobacter pylori eradication often increases platelet counts in patients with chronic idiopathic thrombocytopenic purpura (ITP). In addition, H. pylori has been shown to induce platelet activation (CD62p or P-selectin expression) in previous studies. We assessed the response of platelet count and CD62p expression after eradication therapy in patients with ITP and H. pylori infection.
  
  
  RESULTS
  We prospectively studied 15 ITP patients diagnosed with H. pylori infection by serology and breath test. A follow-up breath test was used to document eradication. Two out of 15 patients showed improvement in platelet counts after 6 months, 1 of which may have had drug-induced thrombocytopenia. Overall, certain platelet response rate in our series was 6.7% (1/15). We found that platelet CD62p expression by flow cytometry was elevated in 10/15 (66.7%) H. pylori-infected patients, which is a statistically significant difference when compared with 3/33 (9.1%) control ITP patients seronegative for H. pylori (p = 0.002). In addition, eradication therapy decreased CD62p expression (p = 0.04). However, reduction in platelet activation was not associated with an increase in platelet counts (mean 72.4 x 10(9)/l before and 68.7 after therapy; p = 0.4).
  
  
  CONCLUSIONS
  In our series, platelet activation was common in ITP patients with H. pylori, and eradication therapy decreased platelet activation but seldom increased platelet counts. Increased platelet CD62p expression is a putative link between chronic infections and atherosclerosis, but further study is needed to clarify the implications of our observation.
authors.affiliation: Wallace H. Coulter Platelet Laboratory, Division of Hematology/Oncology, UM Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA. eahn@med.miami.edu
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Ahn
authors.forename: Maike P
authors.initials: MP
authors.lastname: Tiede
authors.forename: Wenche
authors.initials: W
authors.lastname: Jy
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Bidot
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fontana
authors.forename: Yeon S
authors.initials: YS
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology; D001944:Breath Tests; D002908:Chronic Disease; D005260:Female; D005786:Gene Expression Regulation; D016481:Helicobacter Infections / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D015539:Platelet Activation; D010976:Platelet Count; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000150:complications
chemical_list: D019007:P-Selectin