Long term platelet responses to Helicobacter pylori eradication in Canadian patients with immune thrombocytopenic purpura.
This prospective Canadian pilot study assesses the platelet response rate in H. pylori positive and negative patients and evaluates potential mechanisms to explain response. Patients with ITP received H. pylori eradication therapy and platelet counts at day 56 were used to assess response. Gastric permeability, stool H. pylori antigen and serum CagA anti-body were done at baseline and at day 60. Twenty-two patients were enrolled with an overall response rate of 27% (6/22). The prevalence of H. pylori was 18% (4/22). Seventy-five percent of the H. pylori positive patients (3/4) achieved a response compared to 17% (3/18) of the H. pylori negative patients (P < 0.05). Seventy-five percent of complete responders have demonstrated long-term ongoing responses at 48 months of follow-up. A trend towards lower post-eradication gastric permeability in responders was seen. Although the prevalence of H. pylori is low, H. pylori positive Canadian patients with ITP may benefit from a trial of H. pylori eradication therapy as a safe and effective means to achieve long term platelet response.
Jackson
Shannon C
SC
Division of Hematology, Department of Medicine, Foothills Medical Centre, 1403-29th Street N·W., Calgary, AB, T2N 2T9, Canada. sjackso@ucalgary.ca.
Beck
Paul
P
Division of Gastroenterology, University of Calgary, Calgary, AB, Canada.
Buret
Andre G
AG
Department of Medicine and Department of Biological Sciences, University of Calgary, Calgary, AB, Canada.
O'Connor
Pamela M
PM
Department of Medicine and Department of Biological Sciences, University of Calgary, Calgary, AB, Canada.
Meddings
Jonathan
J
Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Pineo
Graham
G
Division of Hematology, Department of Medicine, Foothills Medical Centre, 1403-29th Street N·W., Calgary, AB, T2N 2T9, Canada.
Poon
Man-Chiu
MC
Division of Hematology, Department of Medicine, Foothills Medical Centre, 1403-29th Street N·W., Calgary, AB, T2N 2T9, Canada.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000097:blood / Q000276:immunology; D001792:Blood Platelets / Q000276:immunology*; D002170:Canada; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000453:epidemiology / Q000276:immunology*; D016036:Seroepidemiologic Studies; D013270:Stomach / Q000382:microbiology; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial