Eliminating Helicobacter pylori (H pylori) may significantly increase platelet counts in patients with idiopathic thrombocytopenic purpura (ITP), according to a prospective study in BMC Hematology.
The authors recommended investigating for H pylori infection in patients with ITP even in the absence of gastrointestinal symptoms, along with considering triple anti-H pylori therapy, followed by periodic monitoring of platelet count to confirm the effectiveness of the therapy, as a first option for H pylori-positive patients with ITP.
The researchers investigated platelet recovery in patients with ITP after H pylori eradication in a study involving 50 patients with chronic ITP (58% male). All of the subjects were between the ages of 18 and 51 years (mean age: 28.6 years). The investigators diagnosed H pylori in 36 patients (72%) who were then treated with triple therapy (40 mg omeprazole once daily, 1000 mg amoxicillin twice daily, and 500 mg clarithromycin twice daily) for 14 days. Uninfected patients received no treatment.
At the end of the sixth month, 10 patients (27.7%) demonstrated complete response, and 18 patients (50%) showed partial response. The 14 uninfected patients, who did not receive any treatment, showed neither complete nor partial response. The researchers found that the sex and age of the patient were not associated with achieving response, but baseline platelet counts and H pylori infection were associated with achieving response.
The pathogenic role of H pylori infection in the development of ITP is still unclear, according the researchers, but they theorize that “H pylori may modify the balance of Fc-receptors on the surface of monocytes.”
1. Aljarad S, Alhamid A, Tarabishi AS, Suliman A, Aljarad Z. The impact of helicobacter pylori eradication on platelet counts of adult patients with idiopathic thrombocytopenic purpura [published online September 20, 2018]. BMC Hematol. doi: 10.1186/s12878-018-0119-y