Platelet count response to Helicobacter pylori eradication for idiopathic thrombocytopenic purpura in northeastern Brazil

Alzira Maria de Castro Barbosa, Rosangela Albuquerque Ribeiro, Cícero Ígor Simões Moura Silva, Francisco Will Saraiva Cruz, Orleancio Gomes Ripardo de Azevedo, Maria Helena da Silva Pitombeira, Lucia Libanez Campelo Braga, Alzira Maria de Castro Barbosa, Rosangela Albuquerque Ribeiro, Cícero Ígor Simões Moura Silva, Francisco Will Saraiva Cruz, Orleancio Gomes Ripardo de Azevedo, Maria Helena da Silva Pitombeira, Lucia Libanez Campelo Braga

Abstract

Background: Several studies have demonstrated that platelet counts in Helicobacter pylori-positive patients with chronic idiopathic thrombocytopenic purpura improved significantly after successful eradication of the infection. However, depending of the geographical region of the study the results have been highly divergent.

Objective: The purpose of this study was to evaluate the effect of H. pylori eradication therapy on platelet count in a cohort of chronic idiopathic thrombocytopenic purpura patients from northeastern Brazil.

Method: H. pylori status was determined in 28 chronic idiopathic thrombocytopenic purpura patients using the rapid urease test and histology. H. pylori-positive patients received standard triple therapy for one week. The effect of the eradication therapy was evaluated using the 13C-urea breath test two to three months after treatment.

Results: The prevalence of H. pylori infection was similar to that found in the general population. Twenty-two patients (78.5%) were H. pylori-positive. Fifteen were treated, 13 (86%) of whom successfully. At six months, 4/13 (30%) displayed increased platelet counts, which remained throughout follow-up (12 months). Platelet response was not associated to mean baseline platelet count, duration of chronic idiopathic thrombocytopenic purpura, gender, age, previous use of medication, or splenectomy.

Conclusions: H. pylori eradication therapy showed relatively low platelet recovery rates, comparable with previous studies from southeastern Brazil. The effect of H. pylori eradication on platelet counts remained after one year of follow-up suggesting that treating H. pylori infection might be worthwhile in a subset of chronic idiopathic thrombocytopenic purpura patients.

Keywords: Blood platelet; Helicobacter pylori eradication; Idiopathic thrombocytopenic purpura.

Copyright © 2017 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

Figures

Figure 1
Figure 1
Flowchart of a cohort of 28 patients with chronic idiopathic thrombocytopenic purpura (cITP) from Northeastern Brazil, 2016.
Figure 2
Figure 2
The mean platelet count ± standard deviation in responsive and non-responsive patients with chronic idiopathic thrombocytopenic purpura (cITP) at baseline and 3, 6 and 12 months after Helicobacter pylori eradication therapy.

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