Helicobacter pylori has recently been postulated to play a role in the pathogenesis of autoimmune diseases, including idiopathic thrombocytopenic purpura (ITP). We investigated the prevalence ofH pylori infection and the effects of its eradication in 61 patients with ITP.H pylori infection was found in 50 patients (83%), an incidence significantly higher than not only healthy volunteers in Japan (60%) but also subjects in other reported ITP series (approximately 43%–71%). In our study, the mean age ofH pylori-positive ITP patients (58.0 years) was significantly higher than that ofH pylori-negative ITP patients (40.5 years). Bacterium eradication efforts were performed in 29 infected ITP patients and succeeded in 27 patients (93%). The 29 patients with eradicatedH pylori infections showed significant increases in platelet counts compared with patients with uneradicated infections or who wereH pylori-negative. During the follow-up period (median, 11.0 months), 16 (55%) of 29 patients achieved a major or a minor response. The patients who achieved a major response had not received previous prednisolone therapy, suggesting a relationship between prednisolone therapy and the response to eradication efforts.The assessment ofH pylori infection and its eradication should be attempted in cases of ITP, because this approach may be a good new strategy for treating some ITP patients, especially elderly Japanese patients. Some regional factors have been suggested as causes ofH pylori-associated ITP.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Graham DY, Lew GM, Klein PD, et al. Effect of treatment ofHelicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer: a randomized, controlled study.Ann Intern Med. 1992;116:705–708.
Forman D, Newell DG, Fullerton F, et al. Association between infection withHelicobacter pylori and risk of gastric cancer: evidence from a prospective investigation.BMJ. 1991;302:1302–1305.
Zentilin P, Savarino V, Garnero A, Accardo S, Seriolo B. IsHelicobacter pylori infection a risk factor for disease severity in rheumatoid arthritis?Gastroenterology. 1999;116:503–504.
De Luis DA, Varela C, de la Calle H, et al.Helicobacter pylori infection is markedly increased in patients with autoimmune atrophic thyroiditis.J Clin Gastroenterol. 1998;26:259–263.
Gasbarrini A, Franceschi F. Autoimmune diseases andHelicobacter pylori infection.Biomed Pharmacother. 1999;53:223–226.
Gasbarrini A, Franceschi F, Tartaglione R, Landolfi R, Pola P, Gasbarrini G. Regression of autoimmune thrombocytopenia after eradication ofHelicobacter pylori.Lancet. 1998;352:878.
Negrini R, Savio A, Poiesi C, et al. Antigen mimicry betweenHelicobacter pylori and gastric mucosa in the pathogenesis of body atrophic gastritis.Gastroenterology. 1996;111:655–665.
McCrae KM, Bussel JB, Mannucci PI, Remuzzi G, Cines DB. Platelets: an update on diagnosis and management of thrombocytopenic disorders.Hematology (Am Soc Hematol Educ Prog). 2001:282–305.
Francois B, Trimoreau F, Vignon P, Fixe P, Praloran V, Gastinne H. Thrombocytopenia in the sepsis syndrome: role of hemophagocytosis and macrophage colony-stimulating factor.Am J Med. 1997; 103:114–120.
Nagamine T, Ohtuka T, Takehara K, Takagi H, Mori M. Thrombocytopenia associated with hepatitis C viral infection.J Hepatol. 1996;24:135–140.
Hohmann AW, Booth K, Peter V, Gordon DL, Comacchio RM. Common epitope on HIV p24 and human platelets.Lancet. 1993; 342:1274–1275.
Grimaz S, Damiani D, Brosolo P, Skert C, Geromin A, de Pretis G. Resolution of thrombocytopenia after treatment forHelicobacter pylori: a case report.Haematologica. 1999;84:283–284.
Emilia G, Longo G, Luppi M, et al.Helicobacter pylori eradication can induce platelet recovery in idiopathic thrombocytopenic purpura.Blood. 2001;97:812–814.
Kohda K, Kuga T, Kogawa K, et al. Effect ofHelicobacter pylori eradication on platelet recovery in Japanese patients with chronic idiopathic thrombocytopenic purpura and secondary autoimmune thrombocytopenic purpura.Br J Haematol. 2002;118:584–588.
Jarque I, Andreu R, Llopis I, et al. Absence of platelet response after eradication ofHelicobacter pylori infection in patients with chronic idiopathic thrombocytopenic purpura.Br J Haematol. 2001;115:1002–1003.
Asaka M, Kimura T, Kudo M, et al. Relationship ofHelicobacter pylori to serum pepsinogens in an asymptomatic Japanese population.Gastroenterology. 1992;102:760–766.
Fukuda Y, Tomita Y, Sakagami T, Shimoyama T. Epidemiology ofH pylori infection [in Japanese].Nippon Rinsho. 2002;60(suppl 2):40–48.
McMillan R. Therapy for adults refractory chronic immune thrombocytopenic purpura.Ann Int Med. 1997;126:307–314.
Kawai T, Kawakami K, Kudo S, et al. A new serum antibody test kit for evaluation ofHelicobacter pylori eradication.Int Med. 2002;41:780–783.
Cheson BD, Bennett JM, Kantarjian H, et al. Report of an international working group to standardize response criteria for myelodysplastic syndromes.Blood. 2000;96:3671–3674.
Cabtree JE, Lindley IJ. Mucosal interleukin-8 andHelicobacter pylori-associated gastroduodenal disease.Eur J Gastroenterol Hepatol. 1994;6(suppl l):S33-S38.
Shimoyama T, Crabtree JE. Bacterial factors and immune pathogenesis inHelicobacter pylori infection.Gut. 1998;43(suppl 1):S2-S5.
Akiyama H, Onozawa Y. Effect of omeprazole in chronic idiopathic thrombocytopenic purpura.Am J Hematol. 1998;57:91–92.
Luzza F, Imeneo M, Maletta M, et al. Suggestion against an oral-oral rout of transmission forHelicobacter pylori infection: a seroepidemiological study in a rural area.Dig Dis Sci. 1998;43:1488–1492.
Tovey FI, Hobsley M. IsHelicobacter pylori the primary cause of duodenal ulceration?J Gastroenterol Hepatol. 1999;14:1053–1056.
George JN. Initial management of adults with idiopathic (immune) thrombocytopenic purpura.Blood Rev. 2002;16:37–38.
About this article
Cite this article
Ando, K., Shimamoto, T., Tauchi, T. et al. Can Eradication Therapy for Helicobacter pylori Really Improve the Thrombocytopenia in Idiopathic Thrombocytopenic Purpura? Our Experience and a Literature Review. Int J Hematol 77, 239–244 (2003). https://doi.org/10.1007/BF02983780
- Idiopathic thrombocytopenic purpura
- Helicobacter pylori
- Eradication therapy