Frequency of H-Pylori Infection in Immune Thrombocytopenic Purpura
DOI:
https://doi.org/10.51985/JBUMDC2023206Keywords:
Bacteria, Eradication, H. pylori, ITP, Platelet countAbstract
Objective: To determine the frequency of Helicobacter pylori infection in patients with Immune Thrombocytopenia (ITP) and the impact of eradication therapy on platelet counts.
Study design & Setting: It was a cross-sectional study conducted at National institute of blood disease and bone marrow transplant (NIBD) hospital, Karachi, Pakistan from January 2021 to September 2022.
Methodology: Adults between 18 to 70 years of either gender with thrombocytopenia (platelet count less than 100x109/L) with or without bleeding manifestation from last six months were recruited. The immunoassay was used for stool sample to detect H. pylori antigen, eradication therapy was administered and platelet counts were evaluated at 3rd and 6th month of treatment.
Results: Of 120 patients with ITP, the mean age was 36.67±15.32 years, and 76.7% were female. 35.83% had H. pylori positive. The eradication treatment on platelet counts was statistically significant (p=0.001). Median platelet counts at baseline, 3 months and 6 months were 43.50(23.00- 77.00), 136.50 (57.00- 237.00), and 192.00 (130.50-275.50) patients respectively. Platelet counts were statistically different between baseline with three and six months (p=0.007 and p=0.001, respectively).
Conclusion: People with ITP frequently have H. pylori infections, and eradication treatment could contribute to the increase in platelet count.
References
McCRAE KE. Immune thrombocytopenia: no longer
‘idiopathic’. Cleveland Clinic journal of medicine. 2011
Jun;78(6):358. doi: 10.3949/ccjm.78gr.10005
Zainal A, Salama A, Alweis R. Immune thrombocytopenic
purpura. Journal of community hospital internal medicine
perspectives. 2019 ;9(1):59-61. doi.org/10.1080/ 20009666.
1565884
Justiz Vaillant AA, Gupta N. ITP-Immune Thrombocytopenic
Purpura.[Updated 2022 Jul 8]. StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing. 2022.
Barbosa AM, Ribeiro RA, Silva CÍ, Cruz FW, Azevedo OG,
Pitombeira MH, Braga LL. Platelet count response to
Helicobacter pylori eradication for idiopathic thrombocytopenic
purpura in northeastern Brazil. Hematology, Transfusion and
Cell Therapy. 2018;40:12-7. https://doi.org/10.1016/ j.bjhh.
09.005
Ikuse T, Toda M, Kashiwagi K, Maruyama K, Nagata M,
Tokushima K, Ito N, Tokita K, Kyodo R, Hosoi K, Jimbo K.
Efficacy of Helicobacter pylori eradication therapy on platelet
recovery in pediatric immune thrombocytopenic purpuraCase series and a systematic review. Microorganisms.
;8(10):1457. doi.org/10.3390/microorganisms8101457
Hooi JK, Lai WY, Ng WK, Suen MM, Underwood FE,
Tanyingoh D, Malfertheiner P, Graham DY, Wong VW, Wu
JC, Chan FK. Global prevalence of Helicobacter pylori
infection: systematic review and meta-analysis.
Gastroenterology. 2017;153(2):420-9. https://doi.org/10.1053/
j.gastro.2017.04.022
Khoder G, Muhammad JS, Mahmoud I, Soliman SS, Burucoa
C. Prevalence of Helicobacter pylori and its associated factors
among healthy asymptomatic residents in the United Arab
Emirates. Pathogens. 2019;8(2):44. https://doi.org/10.3390/
pathogens8020044
Venneman K, Huybrechts I, Gunter MJ, Vandendaele L,
Herrero R, Van Herck K. The epidemiology of Helicobacter
pylori infection in Europe and the impact of lifestyle on its
natural evolution toward stomach cancer after infection: A
systematic review. Helicobacter. 2018;23(3):e12483. https://doi.
org/10.1111/hel.12483
Muhammad JS, Zaidi SF, Saeed SA, Ishaq M. Current status
of Helicobacter pylori association with haematological and
cardiovascular diseases: A mini review. Journal of Pakistan
Medical Association. 2017;67(6):907.
TAN HJ, GOH KL. Extragastrointestinal manifestations of
Helicobacter pylori infection: facts or myth? A critical review.
Journal of Digestive Diseases. 2012;13(7):342-9. https://doi.
org/10.1111/j.1751-2980.2012.00599.x
Kim BJ, Kim HS, Jang HJ, Kim JH. Helicobacter pylori
eradication in idiopathic thrombocytopenic purpura: a metaanalysis of randomized trials. Gastroenterology research and
practice. 2018;2018. https://doi.org/10.1155/2018/6090878
Antony A, Karthick R, Ali M, Chenthil K. Prevalence of H.
pylori in Immune Thrombocytopenic Purpura (ITP) in a
tertiary care center, South India.
Ihtesham A, Maqbool S, Nadeem M, Janjua MB, Sundus O,
Naqqash AB, Mohamed WI, Haider ST, Ahmad M, Mustafa
MA, Mehboob HO. Helicobacter pylori induced Immune
Thrombocytopenic Purpura and perspective role of
Helicobacter pylori eradication therapy for treating Immune
Thrombocytopenic Purpura. AIMS microbiology.
;7(3):284. doi: 10.3934/microbiol.2021018
Shaikh KH, Ahmed S, Ayyub M, Anwar J. Association of
Helicobacter pylori infection with idiopathic thrombocytopenic
purpura. JPMA. The Journal of the Pakistan Medical
Association. 2009;59(10):660.
Kakar JU, Sultan S, Irfan SM, Zeeshan R, Rabbani U.
Frequency of Helicobactor pylori infection among adult
patients with chronic immune thrombocytopenia: A Pakistani
Perspective. Journal of Applied Hematology. 2014;5(2):54.
DOI: 10.4103/1658-5127.137144
Keikha M, Sahebkar A, Yamaoka Y, Karbalaei M. Helicobacter
pylori cagA status and gastric mucosa-associated lymphoid
tissue lymphoma: a systematic review and meta-analysis.
Journal of Health, Population and Nutrition. 2022;41(1):1-1
Wroblewski LE, Peek Jr RM, Wilson KT. Helicobacter pylori
and gastric cancer: factors that modulate disease risk. Clinical
microbiology reviews. 2010 Oct;23(4):713-39. DOI:
https://doi.org/10.1128/cmr.00011-10
Campuzano-Maya G. Proof of an association between
Helicobacter pylori and idiopathic thrombocytopenic purpura
in Latin America. Helicobacter. 2007 Jun;12(3):265-73.
https://doi.org/10.1111/j.1523-5378.2007.00502.x
Ando K, Shimamoto T, Tauchi T, Ito Y, Kuriyama Y, Gotoh
A, Miyazawa K, Kimura Y, Kawai T, Ohyashikia K. Can
eradication therapy for Helicobacter pylori really improve
the thrombocytopenia in idiopathic thrombocytopenic purpura?
Our experience and a literature review. International journal
of hematology. 2003 Apr;77:239-44.
Kuwana M. Helicobacter pylori-associated immune
thrombocytopenia: clinical features and pathogenic
mechanisms. World Journal of Gastroenterology: WJG. 2014
Jan 1;20(3):714. doi: 10.3748/wjg.v20.i3.714
Fujimura K, Kuwana M, Kurata Y, Imamura M, Harada H,
Sakamaki H, Teramura M, Koda K, Nomura S, Sugihara S,
Shimomura T. Is eradication therapy useful as the first line
of treatment in Helicobacter pylori-positive idiopathic
thrombocytopenic purpura? Analysis of 207 eradicated chronic
ITP cases in Japan. International journal of hematology. 2005
Feb;81:162-8.
Gasbarrini A, Franceschi F, Tartaglione R, Landolfi R, Pola
P, Gasbarrini G. Regression of autoimmune thrombocytopenia
after eradication of Helicobacter pylori. The Lancet. 1998
Sep 12;352(9131):878. DOI:https://doi.org/10.1016/S0140-
(05)60004-9
Sheema K, Ikramdin U, Arshi N, Farah N, Imran S. Role of
Helicobacter pylori eradication therapy on platelet recovery
in chronic immune thrombocytopenic purpura.
Gastroenterology Research and Practice. 2017 Jan 17;2017.
https://doi.org/10.1155/2017/9529752
Gan GG, Norfaizal AL, Bee PC, Chin EF, Habibah AH, Goh
KL. Helicobacter pylori infection in chronic immune
thrombocytopenic purpura patients in Malaysia. Med J
Malaysia. 2013 Jun 1;68(3):231-3.
Hwang JJ, Lee DH, Yoon H, Shin CM, Park YS, Kim N. The
effects of Helicobacter pylori eradication therapy for chronic
idiopathic thrombocytopenic purpura. Gut and Liver. 2016
May;10(3):356. doi: 10.5009/gnl14483
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