Helicobacter pylori Eradication in Adult Patients with Acute Idiopathic Thrombocytopenic Purpura (ITP)

Different studies have investigated the link between helicobacter pylori and extra digestive diseases such as idiopathic thrombocytopenic purpura. However, the relationship between ITP and H pylori is less clear. Most of the studies have focused on H pylori eradication in chronic ITP, so we focused on the effect of H pylori eradication on chronicity of ITP in adult patients with ITP.

Eighty five patients with acute ITP whose platelet count were less than 30x109/L were enrolled to the study. Urea breath test (UBT) was carried out for all the patients and based on its results; the patients were divided into 3 groups: Group I: H pylori positive patients who underwent standard triple therapy. Evaluation of H pylori eradication for this group was carried out one month and six months after the treatment. Group II: ITP patients negative for H pylori and Group III: ITP patients' positive for H pylori but without eradication therapy.

52(61.2%) patients were female and 33(38.8%) were male with mean age of 34.8±12.2 years. There was no significant difference between the mean age and gender in different groups. No significant difference was seen in mean platelet count at the baseline among the groups, but there was a significant statistical difference in mean platelet between the groups at the end of the first month. However, a significant difference was not seen in mean platelet count in months 2 to 6. Chronicity in group I was statistically less than the group III. Also, the chronicity rate in non-infected ITP patients was lower than the H pylori positive patients (P=0.03). Likewise, the chronicity rate was lower in the intervention group than in the control group (P=0.035).

Our results show that eradication of H pylori can reduce the chronicity rate in adult patients with ITP. Further studies on larger number of patients with longer follow-up are recommended.