Thrombocytopenia Association with H pylori Infection
Jawad Khan First, Saira Nasr Malik, Komal Iqbal, Ansa Rehman, Safia Rehman And Neelum Ahmad
Department of Hematology/Gastroenterology, Pakistan
*Corresponding Author: Saira Nasr Malik, Department of Hematology/
September 19, 2022; Published: September 22, 2022
Objective: To observe the presence of thrombocytopenia associated with confirmed chronic H pylori infection.
Study Design: Descriptive crossectional study.
Place and Duration of Study: Khyber Teaching Hospital and Police and Services Hospital Peshawar.
Methodology: Those patients who were diagnosed with confirmed H pylori infection where included in this study. Total number of patients were 230. Both out patients and admitted patients were included. The age range was between 20 to 70 years. strict exclusion criteria was followed as thrombocytopenia’s can be caused by multiple other diseases like HCV , HBV , cirrhosis due to other causes like autoimmune hepatitis, primary biliary cholangitis, NASH, primary sclerosing cholangitis, certain drugs , other autoimmune diseases affecting multiple organs like SLE. Also those patients were included who didn’t received any H pylori eradication therapy in past. H pylori was diagnosed by stool antigen which is the most sensitive test for H pylori diagnoses after confirming that patient was not on PPI and didn’t take any antibiotics in last 2 weeks. Platelets counts were measured by automated hematological analyzer followed by peripheral smear for confirmation. Data was analyzed by spss 17 and presented with frequencies and percentages, chi-square was applied and p value < 0.05 was considered as significant.
Results: Out of total 230 patients, 31 patients were found to have thrombocytopenia after following exclusion criteria. 19 out of 31 were above 50 years. Range of platelet counts were between 60000 to 100000, P value was 0.001. Number of male and female patients were same so gender difference was insignificant in this study.
Conclusion: Patients presenting with chronic H pylori infection did show thrombocytopenia especially in older patients above 50.
Keywords: Helicobacter pylori; Platelets; Proton Pump Inhibiters; Thrombocytopenia
- Suerbaum S and Michetti P. “Helicobacter pylori infection”. The New England Journal of Medicine 347 (2002): 1175-1186.
- Logan RP and Walker MM. “ABC of the upper gastrointestinal tract: Epidemiology and diagnosis of Helicobacter pylori infection”. BMJ 323 (2001): 920-922.
- Liebman HA and Stasi R. “Secondary immune thrombocytopenic purpura”. (2008): 206-211.
- Fujimura K., 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”. International Journal of Hematology 81 (2005): 162-168.
- Soldinger E., et al. “Multi-resistant idiopathic thrombocytopenia successfully treated by eradication of Helicobacter pylori”. Digestive and Liver Disease 33 (2001): 732.
- Rinaldi CR., et al. “Complete remission in a case of severe multi-resistant idiopathic thrombocytopenic purpura after Helicobacter pylori eradication”. American Journal of Hematology 83 (2008): 683-684.
- de Barbosa AMC., et al. “Platelet count response to Helicobacter pylori eradication for idiopathic thrombocytopenic purpura in northeastern Brazil”. Hematology, Transfusion and Cell Therapy1 (2018): 12-17.
- Rocha AM., et al. “Cytokine profile of patients with chronic immune thrombocytopenia affects platelet count recovery after Helicobacter pylori eradication”. British Journal of Hematology3 (2015): 421-428.
- O’Neill CM., et al. “Ethnic and racial difference in Helicobacter pylori infection in patients with immune thro”.
- Shaikh KH., et al. “Association of Helicobacter pylori infection with idiopathic thrombocytopenic purpura”. Journal of Pakistan Medical Association 10 (2009): 660.
- Gasbarrini A., et al. “Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori”. Lancet 352 (1998): 878.
- Emilia G., et al. “Helicobacter pylori eradication can induce platelet recovery in idiopathic thrombocytopenic purpura”. Blood 97 (2001): 812-814.
- Takahashi T., et al. “Molecular mimicry by Helicobacter pylori CagA protein may be involved in the pathogenesis of H. pylori-associated chronic idiopathic thrombocytopenic purpura”. British Journal of Hematology 124 (2004): 91-96.
- Kodama M., et al. “Immune response to CagA protein is associated with improved platelet count after Helicobacter pylori eradication in patients with idiopathic thrombocytopenic purpura”. Helicobacter 12 (2007): 36-42.
- Hwang JJ., et al. “The effects of Helicobacter pylori erradication therapy for chronic idiopathic thrombocytopenic purpura”. Gut Liver3 (2016): 356-361.
- Umit H and Umit EG. “Helicobacter pylori and mean platelet volume: a relation way before ımmune thrombocytopenia?” European Review for Medical and Pharmacological Sciences 19 (2015): 2818-2823.
- Raza AB and Bilaal MH. “Comparison of platelet counts between pylori infected and non-infected individuals”. P J M H S 10 (2016): 405-408.
- Ali SA and Gaufri NEAM. “Platelet characterization in helicobacter pylori patients”. OAlib 04 (2017): 1-6.
- Sheema K., et al. “Role of Helicobacter pylori eradication therapy on platelet recovery in chronic immune thrombocytopenic purpura. Gastroenterol Res Pract 2017 (2017): 9529752.
- Samson AD., et al. “Helicobacter pylori infection is not correlated with subclinical thrombocytopenia: a cross-sectional study”. Platelets 25 (2014): 221-223.
- Sibanda N., et al. “Helicobacter pylori infection and the platelet count”. New Zealand Journal of Medical Laboratory Science 70 (2016): 96-100.
- Bath PM. “The routine measurement of platelet size using sodium citrate alone as the anticoagulant”. Thrombosis and Haemostasis (1993).