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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

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Abstract

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.

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Correspondence to Kingo Fujimura.

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Fujimura, K., Kuwana, M., Kurata, Y. 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 81, 162–168 (2005). https://doi.org/10.1532/IJH97.04146

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  • DOI: https://doi.org/10.1532/IJH97.04146

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