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

Overview

Journal Int J Hematol

Specialty Hematology

Date 2005 Mar 16

PMID 15765787

Citations 38

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

Affiliations

Soon will be listed here.

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.

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