Eradication Therapy for Helicobacter Pylori in Idiopathic thrombocytopenic Purpra
Hala M Fahmy1, Nehad M Twfik 1 , Ahmed Murad Hashem 1 , Maha Gaafar 2
1Department of Internal Medicine ,Faculty of Medicine, Cairo University; Egypt.
2 Department of clinical and chemical pathology; Faculty of Medicine ; Cairo University;Egypt *
Abstract: Background: Association between Helicobacter pylori and idiopathic thrombocytopenic purpura (ITP) has previously been reported. It has also been shown that eradication of H. pylori can increase platelet counts in patients with ITP. The aims of this study were to determine the prevalence of H. pylori infection in patients with ITP in Egypt, and the effect of bacterial eradication on their platelet counts. Subjects and methods: The study included 50 cases of ITP patients 28 females and 22 males with mean age of 33.24 ± 12.44years. 50 healthy individuals who are age and sex matched served as a control group. Testing for H pylori infection was done by serological testing for H.pylori serum antibodies andH.pylori stool antigen test. Results: H. pylori infection in patients with ITP was significantly higher than in control individuals (82.0% and 46.0%, respectively , p = 0.000), no statistical significant difference between H.pylori stool Ag and Abs positive and negative ITP patients regarding sex and age , no statistically significant difference between H.pylori infected and non infected ITP patients regarding age, sex and disease duration . ITP patients infected with H pylori were treated with H pylori eradication regimen, Thirty nine H. pylori infected ITP patients were successfully eradicated .Of them 26 patients (66.6%) showed complete or partial response regarding improvement of platelet counts, meanwhile 13 patients (33.3%) showed no response . No statistically significant difference between responders and non responders regarding age, sex, duration of disease and steroid treatment before and during the study. Conclusions: According to these results and others from different countries where H. pylori infection rates are high, patients with ITP should be initially tested for H. pylori status, and if present, infection should be eradicated before initiating a drastic conventional ITP treatment .Larger controlled clinical trials are recommended to determine the predictors of response , response rate and durability and optimal time of therapy .
[Hala M Fahmy, Nehad M Twfik , Ahmed Murad Hashem , Maha Gaafar . Eradication Therapy for Helicobacter Pylori in Idiopathic Thrombocytopenic Purpra. J Am Sci 2012;8(10):117-123]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 18
Key words:. H. pylori , idiopathic thrombocytopenic purpura, eradication therapy. Full Text 18