Regression of idiopathic thrombocytopenic purpura after endoscopic mucosal resection of gastric mucosa associated lymphoid tissue lymphoma. Issue 11 (11th October 2004)

• Record Type: Journal Article
• Authors: Noda, M; Mori, N; Nomura, K; Kojima, K; Mitsufuji, S; Yamane, I; Misawa, S; Okanoue, T
• Is Part Of: Gut. Volume 53:Issue 11(2004)
• Page Start: 1698
• Page End: 1700
• Publication Date: 2004-10-11
• Subjects: MALT, mucosa associated lymphoid tissue -- ITP, idiopathic thrombocytopenic purpura -- EMR, endoscopic mucosal resection -- H&E, haematoxylin and eosin -- T-FISH, tissue fluorescence in situ hybridisation; idiopathic thrombocytopenic purpura -- endoscopic mucosal resection -- mucosa associated lymphoid tissue -- lymphoma; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.2003.033555
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Recent reports have suggested an association between Helicobacter pylori infection and both gastric mucosa associated lymphoid tissue (MALT) lymphoma and thrombocytopenic purpura. Although treatments eradicating H pylori lead to regression of these diseases in some cases, the exact mechanisms are still controversial. This case report describes a patient with thrombocytopenic purpura accompanied by an early stage gastric MALT lymphoma. Endoscopic mucosal resection of the lesion in this patient led to dramatic regression of thrombocytopenic purpura, and t(11;18)(q21;q21), which means resistance more likely to H pylori eradication therapy, was confirmed by fluorescence in situ hybridisation. There is no evidence of recurrence and his platelet count is within normal limits after 24 months of follow up. This is the first case report describing regression of thrombocytopenic purpura after mucosal resection of a gastric MALT lymphoma. We suggest that while some cases of thrombocytopenic purpura may be induced by H pylori, others may be due to an autoreactive antibody produced by MALT lymphoma B cells.