Poor Platelet Count Response To Helicobacter Pylori Eradication in Patients With Severe Idiopathic Thrombocytopenic Purpura

Introduction: itp is an autoimmune blood disorder in which platelet destruction is mediated by anti-platelet antibodies. the mechanisms of anti-platelet antibodies development are still a little known. the rate of some bacterial or viral agents in cause of itp is well known. recently, some study proposed that h pylori infection may be associated with itp and h pylori eradication can improves platelet counts in infected itp patients. materials and method: a baseline platelet count <50×103 μl for 4 weeks prior to study entry were required. these patients were tested for h. pylori infection by urea breath. all positive h pylori patients received triple therapy for 7 or 14 days to eradicate h pylori infection. these patients followed for six months. results: of 92 patients with itp, h pylori infection was found in 59.7% (55/92). after excluding patients with confounding factors, 41 patients were remained. after h pylori eradication, cr wasn’t obtained in any patients. partial response were obtained only in 3 (7.3%) of the 41 patients and no response in 38 (92.6%) patients. there is a significant difference between the platelet counts of pr and nr groups (p<0.001). conclusion: the results of this study and our previously study showed h pylori eradication therapy has beneficial effect for patients with mild thrombocytopenia but the chance of obtaining a response by h pylori treatment is lower in patients with severe thrombocytopenia.