title: Clinical characteristics and treatment outcomes in patients with Helicobacter pylori-positive chronic immune thrombocytopenic purpura.
abstract: Immune thrombocytopenic purpura (ITP) is the condition caused by increased platelet destruction and or decreased platelet production. Previous studies have demonstrated the association and efficacy of Helicobacter pylori (H. pylori) eradication therapy in patients with chronic ITP. Data in Thai patients, however, are limited. A prospective cross-sectional analytic study was conducted in adult patients with chronic ITP to determine the prevalence and clinical predictive factors of H. pylori infection and evaluate the efficacy of H. pylori eradication therapy. H. pylori-infected patients received eradication therapy (omeprazole 40 mg/day, clarithromycin 1000 mg/day, amoxicillin 2000 mg/day) for 2 weeks. The platelet counts at baseline and monthly for 6 months after the end of treatment were evaluated. Of the 25 patients, 9 patients (36%) had H.pylori infection. H. pylori infection is higher among women than men. There were two clinical factors included 1) relapsed ITP 2) response after the first-line treatment statistically proven to be associated with H. pylori infection with an odds ratio and p value of 7.7, p = 0.035 and ND (not determined due to small sample size), p < 0.001. Nearly 80% of infected patients had the platelet count response after eradication therapy with the median time to response of 4 months. The prevalence of H. pylori infection is modest in Thai adult patients with chronic ITP. A history of relapsed ITP and high quality of response after first-line treatment indicated H. pylori infection. Therefore, the urea breath test should be recommended in patients who have a relapsed ITP condition with a history of good response after first-line therapy.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University , Khon Kaen , Thailand and.
authors.forename: Nattiya
authors.initials: N
authors.lastname: Teawtrakul
authors.forename: Kookwan
authors.initials: K
authors.lastname: Sawadpanich
authors.forename: Chittima
authors.initials: C
authors.lastname: Sirijerachai
authors.forename: Kanchana
authors.initials: K
authors.lastname: Chansung
authors.forename: Chinadol
authors.initials: C
authors.lastname: Wanitpongpun
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D016481:Helicobacter Infections / Q000097:blood* / Q000188:drug therapy* / Q000276:immunology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000382:microbiology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chronic ITP; H. pylori infection; clinical characteristics