Eradication of Helicobacter pylori may lead to improvement of chronic immune thrombocytopenic purpura (ITP), although its efficacy over time is uncertain. We report the results of H pylori screening and eradication in 75 consecutive adult patients with ITP. We also used molecular methods to investigate lymphocyte clonality and H pylori genotypes in the gastric biopsies from 10 H pylori-positive patients with ITP and 19 H pylori-positive patients without ITP with chronic gastritis. Active H pylori infection was documented in 38 (51%) patients and successfully eradicated in 34 (89%) patients. After a median follow-up of 60 months, a persistent platelet response in 23 (68%) of patients with eradicated infection was observed; 1 relapse occurred. No differences in mucosal B- or T-cell clonalities were observed between patients with ITP and control participants. Of note, the frequency of the H pylori cagA gene (P = .02) and the frequency of concomitant H pylori cagA, vacAs1, and iceA genes (triple-positive strains; P = .015) resulted statistically higher in patients with ITP than in control participants. All asymptomatic H pylori-positive patients with ITP were suffering from chronic gastritis. Our data suggest a sustained platelet recovery in a proportion of patients with ITP by H pylori eradication alone. Overrepresentation of specific H pylori genotypes in ITP suggests a possible role for bacterium-related factors in the disease pathogenesis.

Helicobacter pylori infection andchronic immune thrombocytopenic purpura: long-term results of bacteriumeradication and association with bacterium virulence profiles / Emilia, Giovanni; Luppi, Mario; Zucchini, Patrizia; Morselli, M; Potenza, Leonardo; Forghieri, Fabio; Volzone, F; Jovic, Gordana; Leonardi, G; Donelli, A; Torelli, Giuseppe. - In: BLOOD. - ISSN 0006-4971. - STAMPA. - 110(12):(2007), pp. 3833-3841. [10.1182/blood-2006-12-063222]

Helicobacter pylori infection andchronic immune thrombocytopenic purpura: long-term results of bacteriumeradication and association with bacterium virulence profiles

EMILIA, Giovanni;LUPPI, Mario;ZUCCHINI, Patrizia;POTENZA, Leonardo;FORGHIERI, Fabio;JOVIC, Gordana;TORELLI, Giuseppe
2007

Abstract

Eradication of Helicobacter pylori may lead to improvement of chronic immune thrombocytopenic purpura (ITP), although its efficacy over time is uncertain. We report the results of H pylori screening and eradication in 75 consecutive adult patients with ITP. We also used molecular methods to investigate lymphocyte clonality and H pylori genotypes in the gastric biopsies from 10 H pylori-positive patients with ITP and 19 H pylori-positive patients without ITP with chronic gastritis. Active H pylori infection was documented in 38 (51%) patients and successfully eradicated in 34 (89%) patients. After a median follow-up of 60 months, a persistent platelet response in 23 (68%) of patients with eradicated infection was observed; 1 relapse occurred. No differences in mucosal B- or T-cell clonalities were observed between patients with ITP and control participants. Of note, the frequency of the H pylori cagA gene (P = .02) and the frequency of concomitant H pylori cagA, vacAs1, and iceA genes (triple-positive strains; P = .015) resulted statistically higher in patients with ITP than in control participants. All asymptomatic H pylori-positive patients with ITP were suffering from chronic gastritis. Our data suggest a sustained platelet recovery in a proportion of patients with ITP by H pylori eradication alone. Overrepresentation of specific H pylori genotypes in ITP suggests a possible role for bacterium-related factors in the disease pathogenesis.
110(12)
3833
3841
Helicobacter pylori infection andchronic immune thrombocytopenic purpura: long-term results of bacteriumeradication and association with bacterium virulence profiles / Emilia, Giovanni; Luppi, Mario; Zucchini, Patrizia; Morselli, M; Potenza, Leonardo; Forghieri, Fabio; Volzone, F; Jovic, Gordana; Leonardi, G; Donelli, A; Torelli, Giuseppe. - In: BLOOD. - ISSN 0006-4971. - STAMPA. - 110(12):(2007), pp. 3833-3841. [10.1182/blood-2006-12-063222]
Emilia, Giovanni; Luppi, Mario; Zucchini, Patrizia; Morselli, M; Potenza, Leonardo; Forghieri, Fabio; Volzone, F; Jovic, Gordana; Leonardi, G; Donelli, A; Torelli, Giuseppe
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/598273
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