Proof of an Association between Helicobacter pylori and Idiopathic Thrombocytopenic Purpura in Latin America

Abstract

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. An algorithm for the study and management of patients with ITP in the post-Helicobacter era is presented.

Helicobacter pylori infection and chronic immune thrombocytopenic purpura: long-term results of bacterium eradication and association with bacterium virulence profiles

“…15,40 In our study, we observed a platelet improvement in 68% of patients with eradicated infection (60.5% of patients infected; 30.6% of total patients with ITP); in about 1500 patients so far reported in the literature, including the 3 US and Spanish cohorts with the lowest responses, the rate of response was about 53%. 17 The highest response rate was reported in cohorts from Italy, Japan, and the United Kingdom. A better response in younger Italian and British patients with high baseline platelet counts and minor duration of the disease, 10 and better results in Japanese patients older than 60 years 40 or in Italian patients not previously treated 7 have been reported.…”

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][28][29][30][31][32][33][34][35] The prevalence (51%) of bacterium …”

“…2 Moreover, in the last few years, several studies, primarily from Italy and Japan, found that the eradication of H pylori in infected patients with chronic immune thrombocytopenic purpura (ITP) leads to a substantial and persistent increase of platelet count in more than half of treated patients. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The pathogenetic mechanisms underlying the relationship between H pylori infection and ITP are still to be elucidated, but some data suggest that the effect of bacterium eradication may depend on either genetic factors of the host, country-related factors, or H pylori strains. 18 The real usefulness of bacterium eradication in ITP over time may be debatable, due to the limited duration of follow-up in most of the studies performed so far.…”

Helicobacter pylori and Hematologic Diseases

“…The series in Colombia presented 32 patients with ITP, 29 (90.6%) of whom were infected with H. pylori. Those 29 patients received eradication therapy, and it was successful in 26 (89.7%) and 21 (80.8%) patients demonstrated a platelet response [189]. The association of H. pylori infection with ITP has not been reported in adults or children from Oceania or the continent of Africa.…”

“…A total of 929 patients received eradication therapy, it was successful in 811 (87.3%) and 472 (58.2%) patients demonstrated a platelet response. In America, only two series have reported an association between H. pylori and ITP: the first in Colombia [189] and the second in Canada [190]. The series in Colombia presented 32 patients with ITP, 29 (90.6%) of whom were infected with H. pylori.…”