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Ryugo Sato, MD; Kazunari Murakami, MD; Koichiro Watanabe, MD; Tadayoshi Okimoto, MD; Hajime Miyajima, MD; Masao Ogata, MD; Eiichi Ohtsuka, MD; Masaaki Kodama, MD; Yoshio Saburi, MD; Toshio Fujioka, MD; Masaru Nasu, MD

Arch Intern Med. 2004;164:1904-1907.

Background  A relationship between Helicobacter pylori infection and idiopathic thrombocytopenic purpura (ITP) has previously been reported. We determined the prevalence of H pylori infection in Japanese patients with chronic ITP and the effect of its eradication on platelet count.

Methods  The study population comprised 53 Japanese adults with chronic ITP and a platelet count of less than 100 x 10³/µL. A ¹³C-urea breath test was performed to determine H pylori infection status. Those patients who were H pylori positive gave written informed consent and received eradication therapy. The effect of H pylori eradication on platelet count was evaluated up to 6 months after therapy. Clinical parameters were compared between responders to the therapy (increase in platelet count) and nonresponders, as well as between H pylori–positive and –negative patients.

Results  Of the 53 patients with chronic ITP in the study, 39 (74%) were H pylori positive. Of the 32 infected patients who received treatment, H pylori was successfully eradicated in 27 patients (84%). In 10 (37%) of these patients, this resulted in a favorable platelet response. A partial response was seen in 5 additional patients (19%). A significant (P<.001) increase in platelet count was demonstrated in patients in whom H pylori was successfully eradicated but not in patients who were unsuccessfully treated or in untreated patients. Current corticosteroid therapy was reported more often in nonresponders than in responders.

Conclusion  Eradication of H pylori may prove effective in increasing platelet count in H pylori–positive patients with chronic ITP.

From the Second Department of Internal Medicine (Drs Sato, Murakami, Watanabe, Okimoto, Miyajima, Ogata, Ohtsuka, and Nasu) and Department of General Medicine (Drs Kodama and Fujioka), Faculty of Medicine, Oita University, and Third Department of Internal Medicine, Oita Prefectural Hospital (Dr Saburi), Oita, Japan. The authors have no relevant financial interest in this article.

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