Helicobacter pylori eradication in patients with chronic immune thrombocytopenic purpura.

Aim: To assess the effect of Helicobacter pylori (H. pylori) eradication on platelet counts in patients with chronic immune thrombocytopenic purpura (cITP).

Methods: A total of 36 cITP patients were included in the study. The diagnosis of H. pylori was done by rapid urease test and Giemsa staining of the gastric biopsy specimen. All H. pylori positive patients received standard triple therapy for 14 d and were subjected for repeat endoscopy at 6 wk. Patients who continued to be positive for H. pylori on second endoscopy received second line salvage therapy. All the patients were assessed for platelet response at 6 wk, 3(rd) and 6(th) months.

Results: Of the 36 patients, 17 were positive for H. pylori infection and eradication was achieved in 16 patients. The mean baseline platelet count in the eradicated patients was 88615.38 ± 30117.93/mm(3) and platelet count after eradication at 6 wk, 3 mo and 6 mo was 143230.77 ± 52437.51/mm(3) (P = 0.003), 152562.50 ± 52892.3/mm(3) (P = 0.0001), 150187.50 ± 41796.68/mm(3) (P = 0.0001) respectively and in the negative patients, the mean baseline count was 71000.00 ± 33216.46/mm(3) and at 6 wk, 3(rd) and 6(th) month follow up was 137631.58 ± 74364.13/mm(3) (P = 0.001), 125578.95 ± 71472.1/mm(3) (P = 0.005), 77210.53 ± 56892.28/mm(3) (P = 0.684) respectively.

Conclusion: Eradication of H. pylori leads to increase in platelet counts in patients with cITP and can be recommended as a complementary treatment with conventional therapy.