Platelet Count Response to Helicobacter Pylori Eradication in Iranian ‎patients With Idiopathic Thrombocytopenic ‎purpura

Abstract

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune hematological disorder characterized by auto antibody-mediated platelet destruction. Although the main cause of ITP remains unclear, but its relationship with some infection was demonstrated. In recent years, many studies have demonstrated improvement of platelet counts in ITP patients after treating Helicobacter pylori infection. The aim of this study was to investigate the effects of H. pylori eradication on platelet count response in Iranian ITP patients.A total of 26 patients diagnosed with both ITP and H. pylori infection. ITP were diagnosed whose platelet counts were less than 100×103/μL. These patients were tested for H. pylori infection by Urea Breath Test and serum H. pylori antibody. All patients received triple therapy for 7 or 14 days to eradicate H. pylori infection. These patients followed for six months.Prevalence of H. pylori was 67.3%. H. pylori eradication achieved in 89.5% (26/29). Of the 26 patients, 15 (57.7%) exhibited a complete response (CR) and 11 (42.3%) were unresponsive. We did not find partial responders. There was a significant difference in the baseline platelet count of responders and non-responders patients (p<0.001). All responders had platelet count ≥50×103/μL and all non-responders had platelet count <50×103/μL.Results of this study revealed that eradication therapy of H. pylori infection can improve platelet counts in ITP patients especially with mild thrombocytopenia and support routine detection and treatment of H. pylori infection in ITP patients in populations with a high prevalence of this infection.

Helicobacter pylori infection prevalence: Is it different in diabetics and nondiabetics?

“…It seems that some extragastrointestinal manifestations of HP occur as a result of this systemic inflammation, which is mentioned in some studies[ 5 ] and includes coronary artery disease, sideroblastic anemia, idiopathic thrombocytopenic purpura, some neurological diseases such as Alzheimer and Parkinson's diseases and biliary system diseases. [ 1 6 7 8 9 10 11 ]…”

Helicobacter pyloriInfection and Insulin Resistance in Diabetic and Nondiabetic Population

“…The mononuclear infiltration is characterized by the local production and systemic diffusion of proinflammatory cytokines affecting remote tissues and organic systems [3, 4]. This systemic inflammation causes some extragastrointestinal side effects of HP including ischemic heart disease [1], sideropenic anemia [5], idiopathic thrombocytopenic purpura [6], neurologic diseases [7], and hepatobiliary diseases [8]. …”

Effect of Helicobacter Pylori eradication on patients with ITP: a meta-analysis of studies conducted in the Middle East

“…Among the articles reviewed, only seven studies concerning the association between H. pylori eradication and response to treatment in patients with ITP in the Middle East were included in this meta-analyze ( Fig. 1 ) [ 18 - 24 ]. Table 1 summarizes the main characteristics and outcomes of the treatments used in the included studies.…”

“…For the two exceptions, after reviewing the description of patients (such as their mean age), we concluded that it was highly probable that they also studied chronic patients. The findings showed that among the seven included articles, three studies confirmed H. pylori infection using the Urea Breath Test (UBT) [ 20 , 21 , 24 ], three other studies [ 19 , 22 , 23 ] used the stool antigen enzyme immunoassay test, and one study [ 18 ] did not report the method used for H. pylori infection documentation. In the 228 patients included in these seven studies, the prevalence of H. pylori infection ranged from 16.6% [ 19 ] to 61.2% [ 18 ].…”