scholarly journals Role of Helicobacter pylori Eradication Therapy on Platelet Recovery in Chronic Immune Thrombocytopenic Purpura

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Khan Sheema ◽  
Ujjan Ikramdin ◽  
Naz Arshi ◽  
Naz Farah ◽  
Sheikh Imran
Keyword(s):  
Bone Marrow ◽  
Helicobacter Pylori ◽  
Immune Thrombocytopenic Purpura ◽  
Eradication Therapy ◽  
Bone Marrow Examination ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Chronic Immune Thrombocytopenic Purpura ◽  
Chronic Itp ◽  
H Pylori

Background. Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys native platelets. In this condition an autoantibody is generated against a platelet antigen. ITP affects women more often than men and is more common in children than adults. Objective. To assess the effect of Helicobacter pylori eradication therapy (HPET) on platelet count in Helicobacter pylori associated chronic immune thrombocytopenic purpura (chronic ITP) in adult. Materials and Methods. It is an interventional prospective study conducted at Liaquat University of Medical and Health Sciences, Jamshoro, from 2014 to 2015. A set of 85 patients diagnosed with chronic ITP were included in the study via convenient sampling. Patients with platelets count < 100 × 109/L for >3 months were selected. They were posed to first-line investigations which comprised complete blood count (CBC) and peripheral blood smear examination followed by second-line tests including bone marrow examination and Helicobacter pylori stool specific antigen (HpSA-EIA). Standard H. pylori eradication therapy was offered and the patients were assessed at regular intervals for 6 months. Results. Of the 85 study patients, 32 (37.6%) were male and 53 (62.3%) were female. Mean ages of H. pylori positive and negative subjects were 43.89 ± 7.06 and 44.75 ± 7.91 years, respectively. Bone marrow examination confirmed the diagnosis and excluded other related BM disorders. H. pylori stool antigen (HpSA) was detected in 34 (40%) patients and hence regarded as H. pylori positive; the rest were negative. Treatment with eradication therapy significantly improved the mean platelet counts from 48.56±21.7 × 109/l to 94.2±26.8 × 109/l. Conclusion. We concluded that the anti-H. pylori eradication therapy improves blood platelet counts in chronic immune thrombocytopenia.

Correlation between Helicobacter Pylori Eradication and Platelet Count in Immune Thrombocytopenic Purpura (ITP).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4003-4003 ◽  
Author(s):  
Jun Ho Jang ◽  
Hyeoung Il Kim ◽  
Hyun Woo Lee ◽  
Seok Yun Kang ◽  
Joon Seong Park ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Systemic Disease ◽  
Eradication Therapy ◽  
Thrombocytopenic Purpura ◽  
Duodenal Ulcers ◽  
Autoimmune Thyroid ◽  
Platelet Counts ◽  
H Pylori

Abstract BACKGROUND: Helicobacter pylori has clearly been implicated in the pathogenesis of gastric and duodenal ulcers, gastritis, and gastric malignancy. Remarkably, eradication of H. pylori from the gastric mucosa has been associated with improvement of systemic disease, including Sjögren’s syndrome, rheumatoid arthritis, autoimmune thyroid disease, and immune thrombocytopenic purpura (ITP). PURPOSE: To investigate the relationship between Helicobacter pylori infection and the clinical features of idiopathic thrombocytopenic purpura (ITP), and to examine the effects of H. pylori eradication on platelet counts. METHOD: A 13C urea breath test (UBT) for H. pylori infection was performed in a 25 consecutive patients with ITP at Ajou University School of Medicine, Suwon, Korea. Patients who tested positive for H. pylori received standard eradication therapy if their platelet count was &lt; 50 x 109/L. RESULTS: H. pylori infection was detected in 18 patients (72%) and eradication therapy was successfully administered to all infected patients. H. pylori infection was not associated with dyspepsia or other clinical or laboratory features. Platelet responses were observed in 6 (33%) of these patients, which lasted for more than 4 months in 4 patients. Platelet associated antibody and anti platelet antibody were negative to all patients. CONCLUSION: H. pylori eradication may improve the platelet counts in some of adults (33%) in whom the ITP is of recent onset.

Helicobacter pylori infection and chronic immune thrombocytopenic purpura: long-term results of bacterium eradication and association with bacterium virulence profiles

Blood ◽  
2007 ◽  
Vol 110 (12) ◽  
pp. 3833-3841 ◽  
Author(s):  
Giovanni Emilia ◽  
Mario Luppi ◽  
Patrizia Zucchini ◽  
Monica Morselli ◽  
Leonardo Potenza ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Immune Thrombocytopenic Purpura ◽  
Long Term Results ◽  
Platelet Response ◽  
Related Factors ◽  
Thrombocytopenic Purpura ◽  
Platelet Recovery ◽  
Chronic Immune Thrombocytopenic Purpura ◽  
H Pylori

AbstractEradication of Helicobacter pylori may lead to improvement of chronic immune thrombocytopenic purpura (ITP), although its efficacy over time is uncertain. We report the results of H pylori screening and eradication in 75 consecutive adult patients with ITP. We also used molecular methods to investigate lymphocyte clonality and H pylori genotypes in the gastric biopsies from 10 H pylori–positive patients with ITP and 19 H pylori–positive patients without ITP with chronic gastritis. Active H pylori infection was documented in 38 (51%) patients and successfully eradicated in 34 (89%) patients. After a median follow-up of 60 months, a persistent platelet response in 23 (68%) of patients with eradicated infection was observed; 1 relapse occurred. No differences in mucosal B- or T-cell clonalities were observed between patients with ITP and control participants. Of note, the frequency of the H pylori cagA gene (P = .02) and the frequency of concomitant H pylori cagA, vacAs1, and iceA genes (triple-positive strains; P = .015) resulted statistically higher in patients with ITP than in control participants. All asymptomatic H pylori–positive patients with ITP were suffering from chronic gastritis. Our data suggest a sustained platelet recovery in a proportion of patients with ITP by H pylori eradication alone. Overrepresentation of specific H pylori genotypes in ITP suggests a possible role for bacterium-related factors in the disease pathogenesis.

scholarly journals Efficacy of Helicobacter pylori Eradication Therapy on Platelet Recovery in Pediatric Immune Thrombocytopenic Purpura-Case Series and a Systematic Review

2020 ◽  
Vol 8 (10) ◽  
pp. 1457
Author(s):  
Tamaki Ikuse ◽  
Masanori Toda ◽  
Kosuke Kashiwagi ◽  
Kimiko Maruyama ◽  
Masumi Nagata ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Immune Thrombocytopenic Purpura ◽  
Pediatric Patients ◽  
Eradication Therapy ◽  
Platelet Response ◽  
Thrombocytopenic Purpura ◽  
Helicobacter Pylori Eradication ◽  
H Pylori ◽  
Helicobacter Pylori Eradication Therapy

Evidence relating to the efficacy of Helicobacter pylori eradication therapy for chronic immune thrombocytopenic purpura (cITP) in childhood is inadequate. The aim of this retrospective study was to determine the efficacy of H. pylori eradication therapy for platelet response in pediatric patients with cITP in our hospital, and to perform a systematic review of previous reports about pediatric patients with cITP who were positive for H. pylori infection and were treated with H. pylori eradication therapy. Analysis of the data of pediatric patients with cITP in our hospital and a systematic review of digital literature databases of studies in pediatric patients with cITP were performed. Data of 33 pediatric patients with cITP from our hospital records showed that the prevalence of H. pylori infection and the rate of response to platelet therapy were 15% and 33.3%, respectively. Data of 706 pediatric patients from 18 previous reports showed that the prevalence of H. pylori infection and rate of platelet response were 23% and 43.8%, respectively. Eradication therapy for H. pylori infection in pediatric cITP patients can be expected to result in a response equivalent to that in the adult population, with fewer adverse effects than other treatments for cITP.

scholarly journals Impact of Helicobacter pylori Eradication Therapy on Platelet Counts in Patients With Chronic Idiopathic Thrombocytopenic Purpura

2015 ◽  
Vol 8 (7) ◽  
pp. 35 ◽  
Author(s):  
Mohamadreza Amiri
Keyword(s):  
Helicobacter Pylori ◽  
Platelet Count ◽  
Eradication Therapy ◽  
Current Treatment ◽  
Thrombocytopenic Purpura ◽  
Stool Antigen Test ◽  
Platelet Counts ◽  
Before And After ◽  
History Of ◽  
H Pylori

<p>This study was a before and after clinical evaluation of <em>Helicobacter pylori</em> eradication on platelet counts in a group of 23 patients with chronic Idiopathic (Autoimmune) thrombocytopenic purpura (CITP). <em>H. pylori </em>infection was identified in patients by a <sup>13</sup>C-urea breath test and confirmed by an <em>H. pylori</em> stool antigen test. Eradication was conducted in patients testing positive. Infected (<em>n</em> = 10) and uninfected (<em>n</em> = 13) patient groups did not differ with respect to age, gender, history of previous splenectomy, treatment with anti-D, current treatment with corticosteroids, or initial platelet count<strong>s</strong>. <em>H pylori</em> eradication was successful in eight infected CITP patients, with two patients not responsive to treatment. Compared to the uninfected group, patients in the infected group who responded to eradication therapy had significantly increased platelet counts after six months (56.2 ± 22.2 <em>vs.</em> 233 ± 85.6 ×10<sup>3</sup> million cells/L; <em>P </em>&lt; 0.01), whereas platelet counts in the non-responding patients and uninfected group did not differ after this period of time. <em>H. pylori</em> eradication promotes significant platelet count improvement in patients with CITP. Thus, all patients with CITP should be tested and treated for<em> H. pylori </em>infections.</p>

Alteration of Circulating Regulatory T Cells in Japanese Adult Patients with Immune Thrombocytopenic Purpura after Eradication of Helicobacter Pylori.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3410-3410
Author(s):  
Koji Miyazaki ◽  
Mikio Danbara ◽  
Manabu Ohsaka ◽  
Yuhko Suzuki ◽  
Ryouichi Horie ◽  
...  
Keyword(s):  
T Cells ◽  
Helicobacter Pylori ◽  
Regulatory T Cells ◽  
Immune Thrombocytopenic Purpura ◽  
Mononuclear Cells ◽  
Eradication Therapy ◽  
Autoimmune Disorder ◽  
Japanese Adult ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts

Abstract Immune thrombocytopenic purpura (ITP) is an autoimmune disorder, and eradication of Helicobacter pylori (HP) has been demonstrated to be an effective and tolerable firstline treatment for the patients infected with HP in Japan. However the mechanism has still remained to be uncovered. Recently CD4+CD25high+Foxp3+ regulatory T cells (Tregs), which regulate autoreactive T cells, have been identified, and suggested to play an important role in pathogenesis of ITP, as well as other autoimmune disorders. It has been shown that Tregs are reduced and suppressed in the ITP patients. And a recent report has demonstrated that the defective Tregs are restored upon the rituximab treatment. However, the effects of HP eradication therapy on Tregs have not been determined. The aim of this study is to investigate the circulating Tregs in ITP patients treated with HP eradication. And we also attempted to elucidate the mechanisms of the treatment. The peripheral blood CD4+CD25high+ Tregs were measured by flow cytometry before and after the treatment in 21 Japanese adults with HP-positive chronic ITP. We also confirmed the expression of Foxp3 in this cellular population with the permeabilized mononuclear cells. Among 21 patients, the platelet counts increased in 13 cases (responders), but not in 9 cases (non-responders). In responders the numbers of Tregs have been restored, but not in non-responders after the treatment. It is interesting here that the amounts of Tregs were still transiently elevated in an early phase (2–3weeks) after the treatment in some non-responders without recovery of the platelet counts. Furthermore, in three cases, who failed in pylorus elimination, Tregs were also transiently increased in number associated with brief recovery of the platelet counts, and reduced to the initial level in about two months. After the successful re-eradication, the numbers of Tregs and platelets have been restored. From these results it is shown that HP eradication can modulate Tregs to increase the platelet counts for ITP patients. We also demonstrate that the increase of Tregs by HP eradication was more rapid than that by rituximab, which required about three months. Further, it might be suggested that there are two phases of the therapy with HP eradication for ITP. In an initial stage, the therapy itself could have an effect modulating the immune systems to potentiate Tregs. Some drugs, such as macrolide antibiotics including clarithromycin have been demonstrated to be a potent immunomodulator. However, this phase is not sufficient for the successful treatment, as shown in the cases of failure in HP elimination. In a retentive stage, extermination of HP is also necessary for sustainment of restored Tregs.

Rituximab efficacy and safety in adult splenectomy candidates with chronic immune thrombocytopenic purpura: results of a prospective multicenter phase 2 study

Blood ◽  
2008 ◽  
Vol 112 (4) ◽  
pp. 999-1004 ◽  
Author(s):  
Bertrand Godeau ◽  
Raphael Porcher ◽  
Olivier Fain ◽  
François Lefrère ◽  
Pierre Fenaux ◽  
...  
Keyword(s):  
Immune Thrombocytopenic Purpura ◽  
Phase 2 ◽  
Open Label ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Chronic Immune Thrombocytopenic Purpura ◽  
Chronic Itp ◽  
Phase 2 Trial ◽  
Phase 2 Study

Abstract Whether rituximab could effectively and safely avoid splenectomy for adults with chronic immune thrombocytopenic purpura (ITP) remains unresolved. A multicenter, prospective, open-label, single-arm, phase 2 trial was conducted to assess rituximab safety and efficacy in adult splenectomy candidates with chronic ITP. Sixty patients with chronic (≥ 6 months) ITP and platelet counts less than 30 × 109/L received a weekly intravenous infusion of rituximab (375 mg/m2) for 4 weeks. All other ITP treatments were stopped. A good response was defined as a platelet count 50 × 109/L or more, with at least a doubling of the initial value at 1 and 2 years after the first rituximab infusion. Patients who required another treatment during follow up were considered nonresponders. Sixteen patients experienced transient side effects that necessitated treatment discontinuation for only 1. Good 1-year responses were obtained in 40% of the patients (24/60 [95% confidence interval: 28%-52%]). At 2 years, 33.3% (20/60 patients) had good responses and 6.7% (4/60) had sustained platelet counts of 30 × 109/L or more without treatment. Thirty-six (60%) patients failed to respond; 25 underwent splenectomy. Based on these results, rituximab was an apparently safe and effective splenectomy-avoiding option in some adults with chronic ITP. This trial is registered at http://clinicaltrials.gov as NCT00225875.

scholarly journals PLATELET COUNT RESPONSE TO HELICOBACTER PYLORI ERADICATION IN IRANIAN ‎PATIENTS WITH IDIOPATHIC THROMBOCYTOPENIC ‎PURPURA

2012 ◽  
Vol 4 (1) ◽  
pp. e2012056 ◽  
Author(s):  
Mohammad Erfan Zare
Keyword(s):  
Helicobacter Pylori ◽  
Platelet Count ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Eradication Therapy ◽  
Complete Response ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Count Response ◽  
Significant Difference ◽  
H Pylori

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune hematological disordercharacterized by auto antibody-mediated platelet destruction. Although the main cause of ITPremains 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/μLand 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 andtreatment of H. pylori infection in ITP patients in populations with a high prevalence of this infection.

scholarly journals An Unusual Cause of Secondary ITP in a 34-Year-Old Hispanic Male

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ayrton Bangolo ◽  
Mohamed Ahmed ◽  
Ali Atoot ◽  
Ashraf Mahmoud ◽  
Chibuzo Agbakwuru-Onyike ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Platelet Count ◽  
Case Report ◽  
Geographic Distribution ◽  
Immune Thrombocytopenic Purpura ◽  
Severe Thrombocytopenia ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
H Pylori ◽  
Hispanic Male

Secondary immune thrombocytopenic purpura (ITP) associated with Helicobacter pylori (H. pylori) infection has been described in the literature. It appears to have a geographic distribution; mostly encountered in countries with a higher prevalence for H. pylori such as Italy or Japan. H. pylori eradication has been recommended in the management of ITP with studies showing improvement in the platelet count in some patients. Substantial platelet count increases in patients with severe thrombocytopenia (platelet counts <30 × 103 microliter), however, are uncommon with H. pylori treatment alone. Here, we present a 34-year-old Hispanic male with worsening chronic thrombocytopenia that resolved following eradication of his H. pylori infection. Herein, we highlight a rare and reversible cause of secondary ITP. With this case report, we hope to encourage physicians to include H. pylori testing in the evaluation of thrombocytopenia.

scholarly journals Effect of Helicobacter pylori infection on the first-line treatment outcomes in patients with immune thrombocytopenic purpura

2021 ◽  
Author(s):  
Ali Dogan ◽  
Omer Ekinci ◽  
Senar Ebinc
Keyword(s):  
Helicobacter Pylori ◽  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Eradication Therapy ◽  
Line Treatment ◽  
First Line ◽  
Thrombocytopenic Purpura ◽  
Significant Difference ◽  
H Pylori ◽  
First Line Treatment

Background: Helicobacter pylori (H. pylori) eradication therapy is known to increase the platelet count, but in immune thrombocytopenic purpura (ITP), the effect of H. pylori infection on the response to treatment is not clear. This study aims to determine whether the response to the first–line treatment is affected by the states of H. pylori–positivity and –negativity in ITP patients. Methods: Adult newly diagnosed or chronic ITP patients who had not received eradication therapy for H. pylori infection were included. Characteristics of the patients, presence and severity of bleeding, initial platelet count, administered treatments, and treatment response rates were inspected. Results: Of 119 total patients, 32 (26.9%) were H. pylori–positive, 87 (73.1%) were H. pylori–negative. The most common treatment was standard–dose steroid in both groups (62.5% vs 68.9%, p=0.524). Rates of complete response, partial response, no response were comparable for the two groups (respectively, 75% vs 73.6%, and 18.8% vs 19.5%, and 6.2% vs 6.9%), and there was no significant difference between the groups (p=0.283). Conclusion: It can be stated according to the present study that; in ITP patients in whom treatment is indicated, the response to the first–line treatment without the administration of H. pylori eradication therapy is comparable between H. pylori–positive and H. pylori–negative patients. Keywords: Helicobacter pylori, immune thrombocytopenic purpura, first-line treatment

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