The Mystery Bug: Helicobacter Pylori. Effect of Eradication on Platelet Counts in Patients with Immune Thrombocytopenic Purpura

OBJECTIVES: 1. To determine the prevalence of H. pylori infection in patients diagnosed to have Immune Thrombocytopenic Purpura.2. To assess the effect of eradication of H. pylori infection on the platelet count of patients with ITP 3. To identify and evaluate other factors that may influence the changes in platelet counts of the studied patient group. SETTING AND DESIGN: This study was Prospective Interventional study conducted at (JIPMER), Puducherry, India. METHODs AND MATERIALS: All ITP patients who attended the haematology clinic were considered for study. Baseline blood investigations and endoscopic antral biopsy was done for all the patients. Diagnosis of H. pylori was done by urease test or histologically by Giemsa staining. If either or both the tests were positive, the patient was considered to have a positive H. pylori status. The standard triple therapy, was used for eradication of H. pylori and those who tested negative for H. pylori, were included in the second group, and continued on their conventional therapy for ITP. Both the groups of patients were followed up at 2, 6 and 10 weeks of enrolment. Their clinical status, number of bleeding episodes and adverse reaction to drugs if any, were recorded. Blood investigation for platelet count was done for all patients at the follow up visit. STATISTICAL ANALYSIS: Statistical analysis of the findings was done using Graph Pad Instat Software, version 3 (Graph Pad, San Diego, CA, USA). RESULTS: 1. Higher incidence of ITP among females and in patients with low socioeconomic status and more number of family members.2. Significant increase in platelet counts in case group after 6-10 weeks of eradication of H. pylori infection. CONCLUSION: There is a significant improvement in platelet counts of Immune thrombocytopenic purpura patients at 6 -10 weeks of therapy.