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Abstract
Background
Helicobacter pylori (H. pylori) have been implicated in the pathogenesis of some autoimmune diseases including idiopathic thrombocytopenic purpura (ITP). Several studies have recently shown a high prevalence of H. pylori infection in patients with ITP, and reported platelet recovery after bacterial eradication therapy. The prevalence of H. pylori infection, and the effect of its eradication, in Korean patients with chronic ITP were investigated.
Methods
The study included 35 patients, from 8 hospitals, with chronic ITP. The H. pylori infection was assessed by the urea breath test, rapid urease test or microbial culture. H. pylori eradication was performed with the amoxicillin, clarithromycin and omeprazole regimen for 7 days, or the bismuth, metronidazole and tetracycline regimen for 10 days. Eradication was assessed by urea breath test 4 weeks
Results
Thirty five patients with chronic ITP were evaluated, including 12 males and 23 females, with a median age of 57 years (range 30～79). The median platelet count before eradication was 23,000/μL (range 4,000～66,000/μL). Sixteen patients had previously undergone a splenectomy. The H. pylori infection was found in 23 (65%) of the 35 patients. Eradication, was performed in 21 patients, and 6 (28.5%) had a significant increase in their platelet counts after both 2 weeks and 2 months. The median response duration was 7.6 months, ranging from 1～27 months.
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Fig. 1.
Courses of platelet counts in responsive patients after eradication. Day 0 indicates the first day of initial eradication treatment.
Table 1.
Patients characteristics
| Total number of patients | 35 |
| Sex (male/female) | 12/23 |
| Age (range/median, years) | 30～79/57 |
| H. pylori infectivity | |
| (+) | 23 |
| (-) | 12 |
| Platelet count (range/median, μL) | 4,000～66,000/23,000 |
| No of previous treatment | |
| 0 | 3 |
| 1 | 9 |
| 2 | 8 |
| ≥3 | 15 |
| Splenectomy | 16 |
| Eradication regimen | |
| CAO∗ | 13 |
| BMT† | 8 |
| Time from diagnosis to eraddication (range/median, years) | 0.6～19/2.6 |
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