1.Efficacy of helicobacter pylori eradication as an upfront treatment of secondary immune thrombocytopenia: an experience from Pakistan
Sadia Sultan ; Mohammed Irfan ; Jamaluddin Kakar ; Miray Hasan
The Medical Journal of Malaysia 2016;71(2):53-56
Background: The effect of Helicobacter-pylori eradication
therapy on the platelet counts in patients with immune
thrombocytopenia is still debatable. The aim of this study
was to assess the response rates of standard triple
eradication therapy in secondary immune thrombocytopenia
with Helicobacter pylori infection.
Methods: From January 2012 to December 2013, 197
patients were diagnosed to have immune thrombocytopenia,
out of which 22(11.1%) patients infected with HelicobacterPylorus
were enrolled in this study. Helicobacter-Pylori
infection was documented by Helicobacter-pylori stool
antigen enzyme immunoassay method. All positive patients
were put on triple eradication therapy. The responses rates
to treatment were defined as per International Working
Group on ITP.
Results: Mean age of patients was 43.18±12.5 years. There
were 10(45.5%) males and 12 (54.5%) females. Of the 22
patients, 7(31.8%) exhibited a complete response (CR) to Hpylori
eradication therapy; 10(45.4%) attained a response;
and 5(22.7%) had no response. Mean base line platelet
counts were 53.36±24.5x109
/l, while platelet counts at 4 week
following eradication was 80.86±51.0x109
/l (P=0.003). The
predictive factor of response following eradication therapy
was baseline platelet counts. Virtually all responders had
baseline platelet counts >30x109
/l and all non-responders
had <30x109
/l of platelet counts.
Conclusions: Though the prevalence of H-pylori is low, this
study confirmed the efficacy of eradication in increasing the
platelet counts in H-pylori positive patients with ITP. It is an
important measure in short time, safe and very cost effective
to achieve platelets increment. We endorse the routine
detection and eradication treatment of H-pylori infective ITP
patients.
Helicobacter pylori