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KMID : 0366220050400010023
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Korean Journal of Hematology
2005 Volume.40 No. 1 p.23 ~ p.27
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The Clinical Efficacy of Helicobacter pylori Eradication in Patients with Helicobacter pylori-positive Chronic Thrombocytopenic Purpura
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Kim Bong-Seog
Nam Seung-Hyun
Bang Soo-Mee
Lee Jae-Hoon
Do Young-Rok
Kwon Ki-Young
Song Hong-Suk
Ryoo Hun-Mo
Bae Sung-Hwa
Kim Min-Kyoung
Lee Kyoung-Hee
Hyun Myung-Soo
Yuh Young-Jin
Park Eun-Kyung
Lee Sang-Jae
Yoon Sung-Soo
Park Seon-Yang
Kim Byoung-Kook
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Abstract
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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 after treatment. Platelet counts were monitored serially after the end of treatment.
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/microL (range 4,000~66,000/microL). 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.
Conclusion: This study confirmed the efficacy of H. pylori eradication in increasing the platelet count in adult chronic ITP patients. The investigation and eradication of H. pylori infection in ITP patients must be considered a simple and inexpensive tool in management of this chronic disease.
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KEYWORD
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Idiopathic thrombocytopenic purpura, Helicobacter pylori Eradication
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