Background and Objectives:Several recent
reports have demonstrated a close linkage between idiopathic thrombocytopenic purpura (ITP) and Helicobacter pylori(H. pylori) infection in some
patient’s populations. However, the pathogenetic mechanisms of H. pylori-induced thrombocytopenia
remain obscure. Therefore, we investigated the prevalence of H. pylori infection pylori and performed
a comparative analysis of a subset of H.
pylori-infected patients (group A) with non-infected patients (group B)
using the standard statistical methods.Design and Methods:From December
2001 to October 2002, we investigated the presence of gastric H. pylori infection in 30 adult ITP
patients and 19 patients
were treated with standard antibiotic therapy for H. pylori eradication (amoxicillin and clarithromycin plus lansoprazole combination). We used the
standard statisticsto analyze the difference between group A and group B.Results:H. pylori eradication was achieved in 17/19 (89.4%) H.pylori-infected
patients. An improvement of platelet count was observed in 14/19 patients
(73.6%) who achieved the eradication. Five of these patients achieved CR (two
patients were with the acute ITP) and nine patients reached PR. The difference
between the mean platelet count±S.D. before and after H. pylori therapy was statistically
significant in patients with successful decontamination (65±48×109/L vs. 200± 140×109/L; p=0.018). Lymphocyte counts at the
diagnosis of H. pylori infected cases
were significant higher than those of non-infected cases (1.58±0.13×109
Cite this paper
N. Takezako, N. Sekiguchi, A. Tanimura, C. Homma, T. Shikai, Y. Takezako, N. Yamagata and A. Miwa, "Lymphocytosis in Idiopathic Thrombocytopenic Purpura Patients Infected by Helicobacter pylori," Open Journal of Blood Diseases, Vol. 3 No. 1, 2013, pp. 32-35. doi: 10.4236/ojbd.2013.31007.
 G. R. Lee, J. Foerster, J. Lukens, et al., “Wintrobe’s Clinical Hematology,” 10th Edition, In: S. P. Levin, Thrombocytopenia Caused by Immunologic Platelet Destruction, Williams & Wilkins, Baltimore, 1999, pp. 1583-1611.
 H. Frederiksen and K. Schmidt, “The Incidence of Idiopathic Thrombocytopenic Purpura in Adults Increases with Age,” Blood, Vol. 94, No. 3, 1999, pp. 909-913.
 W. Ghanima, B. Godeau, D. B. Cines, et al., “How I Treat Immune Thrombocytopenia: The Choice between Splenectomy or a Medical Therapy as a Second-Line Treatment,” Blood, Vol. 120, No. 5, 2012, pp. 960-969.
 J. N. George, S. H. Woolf, G. E. Raskob, et al., “Idiopathic Thrombocytopenic Purpura: A Practice Guideline Developed by Explicit Methods for the American Society of Hematology,” Blood, Vol. 88, No. 1, 1996, pp. 3-40.
 D. Provan and A. Newland, “Fifty Years of Idiopathic Thrombocytopenic Purpura (ITP): Management of Refractory ITP in Adults,” British Journal of Haematology, Vol. 118, No. 4, 2002, pp. 933-944.
 D. B. Cines and V. S. Blanchette, “Immune Thrombocytopenic Purpura,” The New England Journal of Medicine, Vol. 346, 2002, pp. 995-1008.
 S. Grimaz, D. Damiani, P. Brosolo, C. Skert, A. Geromin and G. de Pretis, “Resolution of Thrombocytopenia after Treatment for Helicobacter pylori: A Case Report,” Haematologica, Vol. 84, 1999, pp. 283-284.
 M. Morselli, L. Potenza, M. Luppi, G. Torelli and G. Emilia, “Immune Thrombocytopenic Purpura and Helicobacter pylori Infection,” Archives of Internal Medicine, Vol. 163, No. 1, 2003, p. 120.
 D. Veneri, M. Franchini, M. Gottardi, M. D’Adda, A. Ambrosetti, M. Krampera, F. Zanetti and G. Pizzolo, “Efficacy of Helicobacter pylori Eradication in Raising Platelet Count in Adult Patients with Idiopathic Thrombocytopenic Purpura,” Haematologica, Vol. 87, 2002, pp. 1177-1179.
 K. Kohda, T. Kuga, K. Kogawa, Y. Kanisawa, K. Koike, G. Kuroiwa, Y. Hirayama, Y. Sato and Y. Niitsu, “Effect of Helicobacter pylori Eradication on Platelet Recovery in Japanese Patients with Chronic Idiopathic Thrombocytopenic Purpura and Secondary Autoimmune Thrombocytopenic Purpura,” British Journal of Haematology, 2002, Vol. 118, No. 2, pp. 584-588.
 M. Hino, T. Yamane, K. Park, T. Takubo, K. Ohta, S. Kitagawa, K. Higuchi and T. Arakawa, “Platelet Recovery after Eradication of Helicobacter pylori in Patients with Idiopathic Thrombocytopenic Purpura,” Annals of Hematology, Vol. 82, No. 1, 2003, pp. 30-32.
 H. Goto, T. Kikuta, A. Ota, et al., “Successful Treatment of Refractory Idiopathic Thrombocytopenic Purpura by Eradication of Helicobacter pylori,” Rinsho Ketsueki, Vol. 42, No. 12, 2001, pp. 1192-1194.
 K. Kohda, K. Koike, T. Kuga, et al., “Remission of Idiopathic Thrombocytopenic Purpura after Eradication of Helicobacter pylori: Report of Two Cases,” Nippon Naika Gakkai Zasshi, Vol. 90, No. 10, 2001, pp. 2069-2070.
 T. Takahashi, T. Yujiri, K. Shinohara, Y. Inoue, Y. Sato, Y. Fujii, 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 Haematology, Vol. 124, No. 1, pp. 91-96.
 A. Asahi, T. Nishimoto, Y. Okazaki, H. Suzuki, T. Masaoka, Y. Kawakami, et al., “Helicobacter pylori Eradication Shifts Monocyte Fcgamma Receptor Balance toward Inhibitory FcgammaRIIB in Immune Thrombocytopenic Purpura Patients,” Journal of Clinical Investigation, Vol. 118, 2008, pp. 2939-2949.
 K. Satoh, “Indications for Helicobacter pylori Eradication Therapy and First-Line Therapy Regimen in Japan: Recommendation by the Japanese Society for Helicobacter Research,” Journal of Gastroenterology, Vol. 37, No. S13, 2002, pp. 34-38. doi:10.1007/BF02990097
 M. F. Neurath, S. Finotto and L. H. Glimcher, “The Role of Th1/Th2 Polarization in Mucosal Immunity,” Nature Medicine, Vol. 8, 2002, pp. 567-573.
 M. Mohammadi, S. Czinn, R. Redline, et al., “Helicobacter-Specific Cell-Mediated Immune Responses Display a Predominant Th1 Phenotype and Promote a Delayed-Type Hypersensitivity Response in the Stomachs of Mice,” Journal of Immunology, Vol. 156, 1996, pp. 4729-4738.
 J. W. Semple, Y. Milev, D. Cosgrave, et al., “Differences in Serum Cytokine Levels in Acute and Chronic Autoimmune Thrombocytopenic Purpura: Relationship to Platelet Phenotype and Antiplatelet T-Cell Reactivity,” Blood, Vol. 87, 1996, pp. 4245-4254.
 M. Kuwana, J. Kaburaki, H. Kitasato, et al., “Immunodominant Epitopes on Glycoprotein IIb-IIIa Recognized by Autoreactive T Cells in Patients with Immune Thrombocytopenic Purpura,” Blood, Vol. 98, No. 1, 2001, pp. 130-139. doi:10.1182/blood.V98.1.130