Abstract：Objective To study the role of Helicobacter pylori (H. pylori) infection in newly diagnosed childhood immune thrombocytopenia (ITP). Methods A total of 495 children with newly diagnosed ITP who were hospitalized for the first time between January 2011 and December 2013 were included as the case group. A total of 123 children with common respiratory tract infection (not ITP or other diseases of blood system) were randomly selected as the control group. All patients were divided into four groups by age: <1 year group, 1-3 years group, 3-7 years group, and 7-14 years group. The incidence of H. pylori infection in all age groups and the clinical outcomes of ITP children with or without H. pylori infection were retrospectively analyzed. Results The incidence rate of H. pylori infection in the case group increased with increasing age. There was no significant difference in the incidence rate of H. pylori infection between the case and the control groups among subjects of the same age (P>0.05). All the ITP patients were not given anti-H. pylori treatment and only received the treatment (glucocorticoid and/or immunoglobulin) for ITP, and their remission rate declined with increasing age. There was no significant difference in the remission rate between the ITP children with H. pylori infection and those without H. pylori infection in the same age group (P>0.05). Conclusions H. pylori infection may not be a major cause of ITP in children, and the clinical outcomes of children with acute ITP are not affected by receiving anti-H. pylori treatment or not.
Graham DY, Kimura K, Shimoyama T, et al. Helicobacter pylori infection in Japan: current status and future options[J]. Eur J Gastroenterol Hepatol, 1994, 6 Suppl 1: S1-S4.
[2]
Scandellari R, Allemand E, Vettore S, et al. Platelet response to Helicobacter pylori eradication therapy in adult chronic idiopathic thrombocytopenic purpura seems to be related to the presence of anticytotoxin-associated gene A antibodies[J]. Blood Coagul Fibrinolysis, 2009, 20(2): 108-113.
Michel M, Cooper N, Jean C, et al. Does Helicobater pylori initiate or perpetuate immune thrombocytopenic purpura? [J]. Blood, 2004, 103(3): 890-896.
[5]
Morimoto N, Takeuchi H, Takahashi T, et al. Helicobacter pylori associated chronic thrombocytopenic purpura and low molecular weight H.pylori proteins[J]. Scand J Infect Dis, 2007, 39(5): 409-416.
[6]
Inaba T, MizunoM, Take S, et al. Eradication of Helicobacter pylori increases platelet count with Immunotic thrombocytopenia in Japan[J]. Eur J Clin Invest, 2005, 35(3): 214-219.
[7]
Ferrara M, Capozzi L, Rosso R. Effect of Helicobacter pylori eradication on platelet count in children with Immunotic thrombocytopenia[J]. Hematology, 2009, 14(5): 282-285.
[8]
Malfertheiner P, Megraud F, òMorain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781.
Neunert C, Lim W, Crowther M, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia[J]. Blood, 2011, 117(16): 4190-4207.
Gasbarrini A, Franceschi F, Tartaglione R, et al. Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori[J]. Lancet, 1998, 352(9131): 878.
Treutiger I, Rajantie J, Zeller B, et al. Does treatment of newly diagnosed idiopathic thrombocytopenic purpura reduce morbidity?[J]. Arch Dis Child, 2007, 92(8): 704-707.
[26]
Treepongkaruna S, Sirachainan N, Kanjaaponkul S, et al. Absence of platelet recovery following Helicobacter pylori eradication in childhood chronic idiopathic thrombocytopenic purpura:a multi-center randomized controlled trail[J]. Pediatr Blood Cancer, 2009, 53(1): 72-77.
[27]
Loffredo G, Marzano MG, Migloorati R, et al. The relationship between immune thrombocytopenic purpura and Helicobacter pylori infection in children: where is the truth? [J]. Eur J Pediatr, 2007, 166(10): 1067-1068.
[28]
Yetgin S, Demir H, Arslan D, et al. Autoimmune thrombocytopenic purpura and Helicobacter pylori infection effectivity during childhood[J]. Am J Hematol, 2005, 78(4): 318.
[29]
Neefjes VM, Heijboer H, Tamminga RY, et al. H.pylori infection in childhood chronic immune thrombocytopenic purpura[J]. Haematologica, 2007, 92(4): 576.
