title: Effect of eradication of Helicobacter pylori in children with chronic immune thrombocytopenia: a prospective, controlled, multicenter study.
abstract: BACKGROUND
  The eradication of Helicobacter pylori has been associated with remission of immune thrombocytopenia (ITP) in approximately half of eradicated patients. Data on children are limited to small case series.
  
  
  METHODS
  Children from 16 centers in Italy, who were less than 18 years of age and diagnosed with chronic ITP (cITP), were screened for H. pylori infection. Positive patients underwent standard triple therapy with amoxicillin, clarithromycin, and omeprazole. The eradication response was defined as follows: complete response, platelet (PLT) count ≥ 150 × 10(9) /L; partial response, PLT count of at least 50 × 10(9) /L; no response, PLT count <50 × 10(9) /L.
  
  
  RESULTS
  Of 244 screened patients, 50 (20%) had H. pylori infection, 37 of which received eradication therapy and completed follow-up. Eradication was successful in 33/37 patients (89%). PLT recovery was demonstrated in 13/33 patients after eradication (39%), whereas spontaneous remission was observed in 17/166 (10%) H. pylori-negative patients (P < 0.005). Responders more often required second line eradication (9/13), whereas a second cycle was required in 3/20 non-responders (P < 0.005).
  
  
  CONCLUSIONS
  Among the large cohort of patients, those who underwent successful H. pylori eradication showed a significantly higher PLT response. Therefore, it may be appropriate to look for H. pylori and eventually eradicate it in children with cITP.
authors.affiliation: Centro di Riferimento di Ematologia ed Oncologia Pediatrica, Università di Catania, Catania, Italy. diberuss@unict.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Russo
authors.forename: Vito
authors.initials: V
authors.lastname: Miraglia
authors.forename: Francesca
authors.initials: F
authors.lastname: Branciforte
authors.forename: Sofia Maria Rosaria
authors.initials: SM
authors.lastname: Matarese
authors.forename: Marco
authors.initials: M
authors.lastname: Zecca
authors.forename: Gianni
authors.initials: G
authors.lastname: Bisogno
authors.forename: Emilia
authors.initials: E
authors.lastname: Parodi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Amendola
authors.forename: Paola
authors.initials: P
authors.lastname: Giordano
authors.forename: Momcilo
authors.initials: M
authors.lastname: Jankovic
authors.forename: Annalisa
authors.initials: A
authors.lastname: Corti
authors.forename: Margherita
authors.initials: M
authors.lastname: Nardi
authors.forename: Piero
authors.initials: P
authors.lastname: Farruggia
authors.forename: Laura
authors.initials: L
authors.lastname: Battisti
authors.forename: Carlo
authors.initials: C
authors.lastname: Baronci
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palazzi
authors.forename: Fabio
authors.initials: F
authors.lastname: Tucci
authors.forename: Stefania
authors.initials: S
authors.lastname: Ceppi
authors.forename: Bruno
authors.initials: B
authors.lastname: Nobili
authors.forename: Ugo
authors.initials: U
authors.lastname: Ramenghi
authors.forename: Domenico
authors.initials: D
authors.lastname: De Mattia
authors.forename: Lucia
authors.initials: L
authors.lastname: Notarangelo
mesh_terms: D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001792:Blood Platelets / Q000187:drug effects*; D002648:Child; D002908:Chronic Disease; D017291:Clarithromycin / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole