title: Development of corpus atrophic gastritis may be associated with Helicobacter pylori-related idiopathic thrombocytopenic purpura.
abstract: BACKGROUND
  A strict correlation between Helicobacter pylori eradication and an increase in platelet count has previously been reported in patients with chronic idiopathic thrombocytopenic purpura (ITP). To clarify the pathogenesis of H. pylori-induced ITP and the factors predicting the platelet response to H. pylori eradication therapy, we evaluated the markers of atrophic gastritis in ITP patients.
  
  
  METHODS
  The study population comprised 31 H. pylori-infected patients with chronic ITP. After undergoing upper gastrointestinal endoscopy and gastric biopsy, all patients received H. pylori eradication therapy. The effect of H. pylori eradication on the platelet count was evaluated for up to 6-54 months after the therapy. The degree of endoscopic gastric atrophy, histological parameters in the gastric mucosa, and serum pepsinogen (PG) levels were compared between platelet responders and nonresponders to the therapy.
  
  
  RESULTS
  H. pylori was successfully eradicated in all patients and a platelet response was seen in 18 (58%) of these patients. The serum pepsinogen (PG) I/II ratio at pretreatment was significantly lower in responders than in nonresponders. The degree of endoscopic gastric atrophy was significantly more severe in responders than in nonresponders. Furthermore, the levels of histological parameters of activity, inflammation, and atrophy in the gastric corpus, but not in the gastric antrum, were significantly more severe in responders than in nonresponders,.
  
  
  CONCLUSIONS
  The development of corpus atrophic gastritis may be a suitable condition for inducing thrombocytopenia. Evaluation of the serum, endoscopic, and histological markers of atrophic gastritis may assist in selecting patients with ITP who are more likely to respond to H. pylori eradication therapy.
authors: Department of Gastroenterology and General Medicine, Oita University, Idaigaoka, Hasama-machi, Yufu, Japan.
authors: Ryugo
authors: R
authors: Sato
authors: Kazunari
authors: K
authors: Murakami
authors: Tadayoshi
authors: T
authors: Okimoto
authors: Koichiro
authors: K
authors: Watanabe
authors: Masaaki
authors: M
authors: Kodama
authors: Toshio
authors: T
authors: Fujioka
references: Blood. 2007 Dec 1;110(12):3833-41
references: 17652264
references: Int J Hematol. 2009 Mar;89(2):142-149
references: 19184277
references: Blood. 1996 Jul 1;88(1):3-40
references: 8704187
references: Gastroenterology. 1998 Aug;115(2):340-7
references: 9679039
references: Lancet. 1995 Jun 17;345(8964):1525-8
references: 7791437
references: Helicobacter. 2001 Dec;6(4):294-9
references: 11843961
references: Am J Gastroenterol. 1996 May;91(5):963-9
references: 8633589
references: Infect Immun. 1990 Jun;58(6):1992-4
references: 2341188
references: Tissue Antigens. 2009 Apr;73(4):353-7
references: 19317746
references: Gastroenterology. 1996 Sep;111(3):655-65
references: 8780570
references: Helicobacter. 2004 Oct;9(5):443-52
references: 15361084
references: Haematologica. 2006 Oct;91(10):1436-7
references: 16963398
references: Br J Haematol. 2004 Jan;124(1):91-6
references: 14675413
references: Am J Med. 2005 Apr;118(4):414-9
references: 15808140
references: J Gastroenterol Hepatol. 2007 Dec;22(12):2233-7
references: 17559384
references: Digestion. 2008;77(2):73-8
references: 18354254
references: Blood. 2009 Feb 5;113(6):1231-40
references: 18945961
references: Platelets. 2005 Mar;16(2):117-9
references: 15823868
references: Platelets. 2006 Jun;17(4):227-30
references: 16769600
references: Int J Hematol. 2003 Apr;77(3):239-44
references: 12731666
references: Platelets. 2005 Aug;16(5):307-11
references: 16011982
references: Eur J Clin Invest. 2005 Mar;35(3):214-9
references: 15733077
references: J Clin Invest. 2008 Aug;118(8):2939-49
references: 18654664
references: Gastroenterol Jpn. 1987 Apr;22(2):133-41
references: 3596151
references: Gastroenterology. 1982 Jul;83(1 Pt 2):204-9
references: 7084603
references: Am J Gastroenterol. 2005 Jun;100(6):1265-70
references: 15929755
references: Jpn J Med. 1987 May;26(2):158-61
references: 3626154
references: Int J Hematol. 2008 Sep;88(2):212-218
references: 18668306
references: Ann Hematol. 2009 Aug;88(8):789-93
references: 19096845
references: Helicobacter. 2007 Feb;12(1):36-42
references: 17241299
references: J Antimicrob Chemother. 2007 Aug;60(2):237-46
references: 17561502
references: Virchows Arch. 2005 Jan;446(1):1-9
references: 15583929
references: Lancet. 1997 May 24;349(9064):1531-6
references: 9167472
references: Gut. 2007 Jun;56(6):772-81
references: 17170018
references: Lancet. 1998 Sep 12;352(9131):878
references: 9742983
references: N Engl J Med. 2002 Oct 10;347(15):1175-86
references: 12374879
references: Int J Hematol. 2006 Feb;83(2):147-51
references: 16513533
references: Am J Gastroenterol. 1996 May;91(5):959-62
references: 8633588
references: Am J Hematol. 2008 May;83(5):376-81
references: 18183613
references: Am J Gastroenterol. 1996 May;91(5):949-53
references: 8633586
references: J Natl Cancer Inst. 1971 Jul;47(1):179-95
references: 5570116
references: Helicobacter. 2007 Jun;12(3):265-73
references: 17493008
references: Arch Intern Med. 2004 Sep 27;164(17):1904-7
references: 15451766
references: Int J Hematol. 2005 Feb;81(2):162-8
references: 15765787
references: Am J Surg Pathol. 1996 Oct;20(10):1161-81
references: 8827022