Helicobacter pylori in esplenectomized patients with immune primary trombocytopenia

Authors

  • Guillermo Gutiérrez-Espíndola <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Especialidades, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Servicio de Hematolog&iacute;a. Ciudad de M&eacute;xico</p>
  • Irazu Gallardo-Wong <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Pediatr&iacute;a, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Unidad de Investigaci&oacute;n en Gastroenterolog&iacute;a. Ciudad de M&eacute;xico</p>
  • Segundo Morán-Villota <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Pediatr&iacute;a, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Unidad de Investigaci&oacute;n en Gastroenterolog&iacute;a.&nbsp;Ciudad de M&eacute;xico</p>
  • Emma Álvarez-Pantoja <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Especialidades, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Servicio de Hematolog&iacute;a. Ciudad de M&eacute;xico</p>
  • Susana Guerrero-Rivera <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Especialidades Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Divisi&oacute;n de Investigaci&oacute;n.&nbsp;Ciudad de M&eacute;xico</p>
  • Jesús Medrano-Contreras <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Especialidades, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Servicio de Hematolog&iacute;a. Ciudad de M&eacute;xico</p>
  • Juan Manuel Gallardo-Montoya <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Especialidades, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Unidad de Investigaci&oacute;n en Enfermedades nefrol&oacute;gicas.&nbsp;Ciudad de M&eacute;xico</p>
  • Luis A. Maillón-García <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Especialidades, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Servicio de Hematolog&iacute;a. Ciudad de M&eacute;xico</p>

Keywords:

Thrombocytopenia, Helicobacter pylori, Blood Platelets

Abstract

Background: Primary Immune Thrombocytopenia (TIP) is an autoimmune disease that accelerates the peripheral destruction of platelets and alters megakaryocytopoiesis. Helicobacter pylori infection and eradication has been associated with an increase in the platelet count in patients with IPT. The aim of this article is to evaluate the platelet response after H. pylori eradication in patients with chronic splenectomized IPT

Methods: Between 2008 and 2009, adult patients with a diagnosis of chronic IPT, splenectomized; They were given breath test with carbon 13-labeled urea (PAU13C). Patients who tested positive received eradication treatment with amoxicillin, omeprazole and clarithromycin for 14 days. After 6 weeks of treatment, a second PAU13C was performed. Baseline platelet counts were performed and every six months until the completion of two years.

Results: 40 patients, 34 women and 6 men were included, PAU13C was positive in 17 patients (42.5%). H. pylori eradication was obtained in 16 patients (94%) confirmed by post-treatment PAU13C. In the follow-up of the patients it was observed that there was increase of platelets in 7 of the patients with eradication of H. pylori, while of the patients not infected in 9 also an increase of platelets was observed.

Conclusions: There were no differences in the increase in platelet count among patients positive or negative to the H. pylori breath test at follow-up at 24 months.

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Author Biography

  • Juan Manuel Gallardo-Montoya, <p>Instituto Mexicano del Seguro Social,&nbsp;Hospital de Especialidades, Centro M&eacute;dico Nacional Siglo XXI,&nbsp;Unidad de Investigaci&oacute;n en Enfermedades nefrol&oacute;gicas.&nbsp;Ciudad de M&eacute;xico</p>

    Los autores han completado y enviado la forma traducida al español de la declaración de conflictos potenciales de interés del Comité Internacional de Editores de Revistas Médicas, y no fue reportado alguno que tuviera relación con este artículo.

References

Cines DB, Bussel JB, Liebman HA, Luning-Prak ET. The ITP Syndrome: pathogenic and clinical diversity. Blood. 2009;113(26):6511-6521.

 

Lambert M, Terry B, Gernsheimer TB. Clinical updates in adult immune thrombocytopenia. Blood. 2017;129(21):2829-2835.

 

Liebman HA, Stasi R. Secondary immune thrombocytopenic purpura. Curr Opin Hematol. 2007;14:557-573

 

Suerbaum S, Michetti P. Helicobacter pylori infection. New England Journal of Medicine. 2002;347(15):1175-1186.

 

Stasi R, Willis F, Shannon M, et al. Infectious Causes of Chronic Immune Thrombocytopenia. Hematol Oncol Clin N Am 23 (2009) 1275–1297.

 

Gasbarrini A, Franceschi F, Tartaglione R, Landolfi R, Pola P, Gassbarrini G. Regression of autoimmune thrombocytopenic after eradication of Helicobacter pylori. Lancet 1998;352(9131):878.

 

Stasi R, Provan D. Helicobacter pylori and Chronic ITP. ASH Hematology. 2008:206-211.

 

Torres J, Leal-Herrera Y, Pérez-Pérez G, Gómez A, Camorlinga-Ponce M, Cedillo-Rivera M, et al. A community-based seroepidemiological study of Helicobacter pylori infection in Mexico. J Infect Dis. 1998;178(4):1089-1094.

 

Estrada-Gómez RA, Parra-Ortega I, Martínez-Barreda C, Ruiz-Argüelles GJ. Helicobacter pylori infection and thrombocytopenia: a single-institution experience in Mexico. Rev Invest Clin. 2007;59:112-115.

 

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.

 

Michel M, Cooper N, Jean C, Frissora C, Bussel JB. Does Helicobacter pylori initiate or perpetuate immune thrombocytopenic purpura? Blood. 2004;103:890-896.

 

Rodeghiero F, Stasi R, Gemsheimer, Michel M, Provan D, Arnold DM, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009;113(11):2386-2393.

 

Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel JB, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010;115(2):168-186.

 

Campuzano-Maya G. Proof of an association between Helicobacter pylori and idiopathic thrombocytopenic purpura in Latin America. Helicobacter. 2007;12:265-273.

 

Suzuky T, Matsushima M, Masui A, Watanabe K, Takagi A, Ogawa Y, et al. Effect of Helicobacter pylori Eradication in Patients with Chronic Idiopathic Thrombocytopenic Purpura-A Randomized Controlled Trial. Am J Gatroenterol 2005;100(6):1265-1270.

 

Kuwana M. What do we learn from immunomodulation in patients with immune thrombocytopenia? Semin Hematol. 2016;53(Suppl 1):S27-30.

 

Sheema K, Ikramdin U, Arshi N, Farah N, Imran S. Role of Helicobacter pylori Eradication Therapy on Platelet Recovery in Chronic Immune Thrombocytopenic Purpura. Gastroenterol Res Pract. 2017;(2017). Article ID 9529752.

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Published

2018-07-17

Issue

Vol. 55 No. Suplemento 4 (2017)

Section

Original Articles

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