Effect of Helicobacter pylori eradication on platelet count in children with chronic idiopathic thrombocytopenic purpura

Recent reports have suggested, particularly in adults, an association between Helicobacter pylori infection (HPI) and chronic idiopatic thrombocytopenic purpura (cITP) with improvement of platelet count after eradication therapy. We investigated the association of HPI and cITP and the effect of HP eradication therapy on thrombocytopenia in a population of 24 children of both sexes mean age 8.0 +/- 0.28 years (range 5.4-10.7 years), affected by cITP (PLT <= 50 x 10(9)/l) lasting more than 6 months. HPI was investigated by Helicobacter pylori stool antigens (HpSA). In eight out 24 patients (33.3%) HP infection was identified positive and bacterial eradication was successful following 7 days of triple therapy (amoxicillin, clarithromicin and proton pump inibitors). A follow-up of platelet count was performed for 1 year after HpSA detection. Six out eight patients (75%) had total recovery of platelet count during the first year after bacterial eradication (PLT before therapy 32.5 +/- 3.5 x 10(9)/l; after 1 year 275 +/- 106.06 x 10(9)/l) (P<0.05), two patients (25%) had partial recovery (PLT before therapy 30 x 10(9)/l, after 1 year 103.5 x 10(9)/l) although not reaching statistical significance (P>0.05). Non-significant differences were found in platelet count between infected and uninfected patients before eradication treatment (PLT 33.0 +/- 2.8 x 10(9)/l versus 34.0 +/- 5.75 x 10(9)/l) (P>0.05), while significant differences were observed after eradication therapy (PLT 315.0 +/- 7.07 x 10(9)/l versus 43.5 +/- 2.12 x 10(9)/l) (P<0.05). HP assessment should be performed in all cITP patients and eradication therapy should be attempted in positive cases.