Prevalence of H. pylori in Immune Thrombocytopenic Purpura (ITP) in a tertiary care center, South India
Abstract
Introduction: Immune thrombocytopenic purpura (ITP) has been linked with Helicobacter Pylori infection.
Objectives: The objective of the present study was to determine the prevalence of H pylori infection in adult ITP patients in a tertiary care center in South India.
Methods: 50 adult patients with ITP in the Department Hematology, Madras Medical College were recruited for a cross -sectional study over a period of 6 months. Biopsy from the antrum was subjected to Rapid urease test to detect H. pylori. A total of 50 patients participated in the study.
Result: The prevalence of H. pylori infection in ITP patients was 36%. The majority of patients were male (78%).
Conclusion: The diagnosis of H. pylori in ITP patients may be considered in high prevalent areas.
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References
Payandeh M, Raeisi D, Sohrabi N, et al. Poor platelet Count Response to Helicobacter Pylori Eradication in Patients with Severe Idiopathic Thrombocytopenic Purpura. Int J Hematol Oncol Stem Cell Res. 2013;7(3):9-14.
Shaikh KH, Ahmed S, Ayyub M, Anwar J. Association of Helicobacter Pylori infection with Idiopathic Thrombocytopenic Purpura, J Pak Med Assoc, 2009;59 (10): 660-663.
Emilia G, Longo G, Luppi M, Gandini G, Morselli M, Ferrara L, et al. Helicobacter pylori eradication can induce platelet recovery in idiopathic thrombocytopenic purpura. Blood. 2001;97(3):812-814. doi: https://doi.org/10.1182/blood.V97.3.812.
Mukai M, Kon Y, Notoya A, Kohno M. Helicobacter pylori associated with idiopathic thrombocytopenic purpura. Am J Med. 2002;113(2):169-171. doi: https://doi.org/10.1016/S0002-9343(02)01134-8.
Michel M, Cooper N, Jean C, Frissora C, Bussel JB. Does Helicobater pylori initiate or perpetuate immune thrombocytopenic purpura? Blood. 2004;103(3):890-896. Epub 2003 Aug 14. doi: https://doi.org/10.1182/blood-2003-03-0900.
Ahn ER, Tiede MP, Jy W, Bidot CJ, Fontana V, Ahn YS. Platelet activation in Helicobacter pylori-associated idiopathic thrombocytopenic purpura: eradication reduces platelet activation but seldom improves platelet counts. Acta Haematol. 2006;116(1):19-24. doi: https://doi.org/10.1159/000092343.
Graham DY, Adam E, Reddy GT, Agarwal JP, Agarwal R, Evans DJ Jr, et al. Seroepidemiology of Helicobacter pylori infection in India. Comparison of developing and developed countries. Dig Dis Sci. 1991;36(8):1084-1088.
Gill HH, Majmudar P, Shankaran K, Desai HG. Age-related prevalence of Helicobacter pylori antibodies in Indian subjects. Indian J Gastroenterol. 1994;13(3):92-94.
Dore SP, Krupadas S, Borgonha S, Kurpad A. The 13C urea breath test to assess Helicobacter pylori infection in school children. Natl Med J India. 1997;10(2):57-60.
Katelaris PH, Tipett GHK, Norbu P, Lowe DG, Brennan R, Farthing MJG. Prevalence of Helicobacter pylori and peptic ulcer and relation to symptoms in a Tibetan refugee population in Southern India. Gut. 1992;33(11):1462-1466.
Misra V, Misra SP, Dwivedi M, et al. 'Point Prevalence of Peptic Ulcer and Gastric Histology in Healthy Indians with Helicobacter pylori Infection. Am J Gastroenterol. 1997;92(9):1487-1491.
Haruma K, Okamoto S, Kawaguchi H, Gotoh T, Kamada T, Yoshihara M, et al. Reduced incidence of Helicobacter pylori infection in young Japanese persons between the 1970s and the 1990s. J Clinic Gastroenterol. 1997;25(4):583-586.
Fujimura K, Kuwana M, Kurata Y, Imamura M, Harada H, Sakamaki H, et al. 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. Int J Hematol. 2005;81(2):162-168.
Liebman HA, Stasi R. Secondary immune thrombocytopenic purpura. Curr Opin Hematol. 2007;14(5):557-573. doi: https://dx.doi.org/10.1097/MOH.0b013e3282ab9904.
Franchini M, Cruciani M, Mengoli C, Pizzolo G, Veneri D. Effect of Helicobacter pylori eradication on platelet count in idiopathic thrombocytopenic purpura: a systematic review and meta-analysis. J Antimicrob Chemother. 2007;60(2):237-246. Epub 2007 Jun 7. doi: https://doi.org/10.1093/jac/dkm195.
Michel M, Khellaf M, Desforges L, Lee K, Schaeffer A, Godeau B. et al. Autoimmune thrombocytopenic Purpura and Helicobacter pylori infection. Arch Intern Med. 2002;162(9):1033-1036. doi: https://dx.doi.org/10.1001/archinte.162.9.1033.
Patel P, Mendall MA, Khulusi S, Northfield TC, Strachan DP. Helicobacter pylori infection in childhood: risk factors and effect on growth. BMJ. 1994;309(6962):1119-1123. doi: https://doi.org/10.1136/bmj.309.6962.1119.
Stasi R, Rossi Z, Stipa E, Amadori S, Newland AC, Provan D. Helicobacter pylori eradication in the management of patients with idiopathic thrombocytopenic purpura. Am J Med. 2005;118(4):414-419. doi: https://doi.org/10.1016/j.amjmed.2004.09.014.
Veneri D, Bonani A, Franchini M, Fedrizzi A, Pizzolo G., Idiopathic thrombocytopenia and Helicobacter pylori infection: platelet count increase and early eradication therapy, Blood Transfus. 2011;9(3):340-342. doi: https://dx.doi.org/10.2450%2F2011.0014-10.
Liebman H. Other immune thrombocytopenias. Semin Hematol. 2007;44(4:5):S24-34. doi: https://doi.org/10.1053/j.seminhematol.2007.11.004.
Gasbarrini A, Franceschi F, Tartaglione R, et al. Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori. Lancet. 1998;352(9131):878. doi: https://doi.org/10.1016/S0140-6736(05)60004-9.
Emilia G, Luppi M, Zucchini P, Morselli M, Potenza L, Forghieri F et al. Helicobacter pylori infection and chronic immune thrombocytopenic purpura: long-term results of bacterium eradication and association with bacterium virulence profiles. Blood. 2007;110(12):3833-3841. Epub 2007 Jul 24. doi: http://dx.doi.org/10.1182%2Fblood-2006-12-063222.
Takahashi T, Yujiri T, Tanizawa Y. Helicobacter pylori and chronic ITP: the discrepancy in the clinical responses to eradication therapy might be due to differences in the bacterial strains. Blood. 2004;104(2):594. doi: https://doi.org/10.1182/blood-2004-02-0702.
Kodama M, Kitadai Y, Ito M, Kai H, Masuda H, Tanaka S et al. Immune response to CagA protein is associated with improved platelet count after Helicobacter pylori eradication in patients with idiopathic thrombocytopenic purpura. Helicobact. 2007;12(1):36-42. doi: https://doi.org/10.1111/j.1523-5378.2007.00477.x.
Galit H. Frydman, Nick Davis, Paul L. Beck, and James G. Fox, Helicobacter pylori Eradication in Patients with Immune Thrombocytopenic Purpura: A Review and the Role of Biogeography, Helicobact. 2015;20(4):239-251. doi: https://doi.org/10.1111/hel.12200.
Everhart JE, Kruszon-Moran D, Perez-Perez GI, Tralka TS, McQuillan G. Seroprevalence and ethnic differences in Helicobacter pylori infection among adults in the United States. J Infect Dis. 2000;181(4):1359-1363. Epub 2000 Apr 13. doi: https://doi.org/10.1086/315384.
Mentis A, Lehours P, Mégraud F. Epidemiology and Diagnosis of Helicobacter pylori infection. Helicobact. 2015;20(1):1-7. doi: https://doi.org/10.1111/hel.12250.
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