Clinical characteristics and treatment outcomes in patients with Helicobacter pylori-positive chronic immune thrombocytopenic purpura. (November 2014)

• Record Type: Journal Article
• Authors: Teawtrakul, Nattiya; Sawadpanich, Kookwan; Sirijerachai, Chittima; Chansung, Kanchana; Wanitpongpun, Chinadol
• Is Part Of: Platelets. Volume 25:Number 7(2014:Nov.)
• Page Start: 548
• Page End: 551
• Publication Date: 2014-11
• Subjects: Blood platelets -- Periodicals; Blood Platelets -- Periodicals; 615.39
• DOI: 10.3109/09537104.2013.841883
• Languages: English
• ISSNs: 0953-7104

Abstract

<abstract> <title>Abstract</title> <p>Immune thrombocytopenic purpura (ITP) is the condition caused by increased platelet destruction and or decreased platelet production. Previous studies have demonstrated the association and efficacy of <italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>) eradication therapy in patients with chronic ITP. Data in Thai patients, however, are limited. A prospective cross-sectional analytic study was conducted in adult patients with chronic ITP to determine the prevalence and clinical predictive factors of <italic>H. pylori</italic> infection and evaluate the efficacy of <italic>H. pylori</italic> eradication therapy. <italic>H. pylori</italic>-infected patients received eradication therapy (omeprazole 40 mg/day, clarithromycin 1000 mg/day, amoxicillin 2000 mg/day) for 2 weeks. The platelet counts at baseline and monthly for 6 months after the end of treatment were evaluated. Of the 25 patients, 9 patients (36%) had <italic>H.pylori</italic> infection. <italic>H. pylori</italic> infection is higher among women than men. There were two clinical factors included 1) relapsed ITP 2) response after the first-line treatment statistically proven to be associated with <italic>H. pylori</italic> infection with an odds ratio and <italic>p</italic> value of 7.7, <italic>p</italic> = 0.035 and ND (not determined due to small sample size), <italic>p</italic> < 0.001. Nearly 80% of infected patients had the platelet count response after eradication therapy with the median time to response of 4 months. The prevalence of <italic>H. pylori</italic> infection is modest in Thai adult patients with chronic ITP. A history of relapsed ITP and high quality of response after first-line treatment indicated <italic>H. pylori</italic> infection. Therefore, the urea breath test should be recommended in patients who have a relapsed ITP condition with a history of good response after first-line therapy.</p> </abstract>