Is eradication therapy useful as the first line of treatment in Helicobacter pylori-positive idiopathic thrombocytopenic purpura? Analysis of 207 eradicated chronic ITP cases in Japan.

Abstract

A retrospective study was performed to determine the prevalence of Helicobacter pylori (H pylori) infection, the effect of H pylori eradication on platelet counts, and the characteristic clinical features of chronic immune or idiopathic thrombocytopenic purpura (ITP) with H pylori infection. H pylori infection was found in 300 patients, a group that was significantly older (P < .005) and had more cases of hyperplastic megakaryocytes in the bone marrow (P = .01) than patients without H pylori infection. H pylori eradication therapy was performed in 207 H pylori-positive ITP cases, and the platelet count response was observed in 63% of the successful eradication group and in 33% of the unsuccessful eradication group (P < .005). In the successful group, the complete remission and partial remission rates were 23% and 42%, respectively, 12 months after eradication. In the majority of responders, the platelet count response occurred 1 month after eradication therapy, and the increased platelet count continued without ITP treatment for more than 12 months. H pylori eradication therapy was effective even in refractory cases, which were unresponsive to splenectomy. In conclusion, H pylori infection was involved in most ITP patients older than 40 years in Japan, and eradication therapy should be the first line of treatment in H pylori-positive ITP patients.

• Authors: Kingo Fujimura, Masataka Kuwana, Yoshiyuki Kurata, Masahiro Imamura, Hiroshi Harada, Hisashi Sakamaki, Masanao Teramura, Kyuhei Koda, Shosaku Nomura, Sayaka Sugihara, Takeshi Shimomura, Tetsuro-Takahiro Fujimoto, Kazuma Oyashiki, Yasuo Ikeda
• Journal: International journal of hematology (Int J Hematol) Vol. 81 Issue 2 Pg. 162-8 (Feb 2005) ISSN: 0925-5710 [Print] Japan
• PMID: 15765787 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Age Distribution
• Anti-Bacterial Agents (therapeutic use)
• Female
• Follow-Up Studies
• Helicobacter Infections (complications, drug therapy, epidemiology)
• Helicobacter pylori
• Humans
• Japan (epidemiology)
• Male
• Middle Aged
• Platelet Count
• Prevalence
• Purpura, Thrombocytopenic, Idiopathic (etiology, microbiology)
• Remission Induction
• Retrospective Studies