International Journal of Hematology

DOI: 10.1532/IJH97.04146 Pages: 162-168

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

1. Graduate School of Biomedical Sciences, Hiroshima University, Department of Hematology and Oncology, Division of Clinical Pharmacotherapeutics, Program for Applied Biomedicine

2. Keio University School of Medicine, Institute for Advanced Medical Research

3. Osaka University Hospital, Department of Blood Transfusion

4. Hokkaido University School of Medicine, Department of Hematology

5. Showa University Fujigaoka Hospital, Department of Hematology

6. Tokyo Komagome Metropolitan Hospital, Department of Internal Medicine

7. Tokyo Women’s Medical University School, Department of Hematology

8. Asahikawa Red Cross Hospital Asahikawa, Department of Internal Medicine

9. Kansai Medical School, Department of Hematology

10. Hiroshima Red Cross Hospital Hiroshima, Department of Hematology

11. Hiroshima University, Department of Hematology, Research Institute for Radiation Biology and Medicine

12. Tokyo Medical School, Department of Hematology

13. Keio University School of Medicine, Department of Internal Medicine

Correspondence to:
Yasuo Ikeda
Tel: 81-82-257-5295
Fax: 81-82-257-5299



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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