Effects of Helicobacter pylori eradication in patients with immune thrombocytopenic purpura

BACKGROUND The relationship between Helicobacter pylori (H. pylori) infection and chronic idiopathic thrombocytopenic purpura (ITP) has been confirmed; however, no clear evidence for the effectiveness of H. pylori eradication on ITP exists thus far. The purpose of this study was to investigate platelet recovery in chronic ITP after H. pylori eradication. METHODS A total of 25 patients (18 male, 7 female; the median age of 55 years) diagnosed with ITP, whose platelet counts were less than 100×10(3)/µL, were enrolled. They were tested for H. pylori infection by the rapid urea test or urea breath test. All patients received triple therapy for 7 or 14 days to eradicate H. pylori infection. RESULTS Of the 25 patients, 23 (92%) were diagnosed with H. pylori infection. Of all the ITP patients, 11 (44%) exhibited a complete response (CR) to H. pylori eradication therapy; 6 (24%), a partial response (PR); and 8 (32%) were nonresponsive (NR). Predictive factors of response after H. pylori eradication therapy were platelet counts at the initial response (27.3% responders among patients with platelet counts <100×10(3)/µL vs 100% responders among patients with platelet counts ≥100×10(3)/µL, P<0.001) and H. pylori infectivity (73.9% responders among the H. pylori positive patients vs 0% responders among the H. pylori negative patients, P=0.032). CONCLUSION This study confirmed the efficacy of H. pylori eradication in increasing the platelet count in ITP patients. Further studies with a larger number of patients are necessary to identify the crucial predictive factors responsible for platelet recovery in chronic ITP patients with the H. pylori infection.