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
Autor: | Hisashi Sakamaki, Masanao Teramura, Kingo Fujimura, Kyuhei Koda, Yasuo Ikeda, Takeshi Shimomura, Masataka Kuwana, Tetsuro-Takahiro Fujimoto, Masahiro Imamura, Sayaka Sugihara, Shosaku Nomura, Yoshiyuki Kurata, Kazuma Oyashiki, Hiroshi Harada |
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Rok vydání: | 2005 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Spirillaceae Splenectomy macromolecular substances Gastroenterology Helicobacter Infections Age Distribution Japan Internal medicine Prevalence Medicine Humans Platelet Retrospective Studies Purpura Thrombocytopenic Idiopathic Hematology biology Helicobacter pylori business.industry Platelet Count Remission Induction Retrospective cohort study Middle Aged bacterial infections and mycoses biology.organism_classification medicine.disease Thrombocytopenic purpura Anti-Bacterial Agents medicine.anatomical_structure Immunology Female Bone marrow business Follow-Up Studies |
Zdroj: | International journal of hematology. 81(2) |
ISSN: | 0925-5710 |
Popis: | A retrospective study was performed to determine the prevalence of Helicobacter pylori (H pylori) infection, the effect of H pylori eradication on platelet counts, and the characteristic clinical features of chronic immune or idiopathic thrombocytopenic purpura (ITP) with H pylori infection. H pylori infection was found in 300 patients, a group that was significantly older (P < .005) and had more cases of hyperplastic megakaryocytes in the bone marrow (P = .01) than patients without H pylori infection.H pylori eradication therapy was performed in 207 H pylori-positive ITP cases, and the platelet count response was observed in 63% of the successful eradication group and in 33% of the unsuccessful eradication group (P < .005). In the successful group, the complete remission and partial remission rates were 23% and 42%, respectively, 12 months after eradication. In the majority of responders, the platelet count response occurred 1 month after eradication therapy, and the increased platelet count continued without ITP treatment for more than 12 months. H pylori eradication therapy was effective even in refractory cases, which were unresponsive to splenectomy. In conclusion, H pylori infection was involved in most ITP patients older than 40 years in Japan, and eradication therapy should be the first line of treatment in H pylori-positive ITP patients. |
Databáze: | OpenAIRE |
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