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Background. Recent studies have suggested a high prevalence of Helicobacter pylori infection in patients with idiopathic thrombocytopenic purpura (ITP) . We report a patient who experienced improvement of uncontrollable thrombocytopenia after Helicobacter pylori eradication whilst receiving chemotherapy for lung cancer. Case. A 56-year-old woman was admitted to our hospital because her chest X-ray film showed a mass and pleural effusion and lung cancer was diagnosed . The thrombocytopenia was considered due to disseminated intravascular coagulation (DIC) since elevated fibrin degradation products (FDP) was observed. The thrombocytopenia was not controlled by 1独立行政法人国立病 院機構 善通寺病 院外科;徳 島市民病 院2外 科,3内 科. 別刷請求先:畠 山茂毅,独 立行政法人国立病 院機構善通寺病院外 科,〒765-8507善 通寺市仙遊町二丁 目1番1号(e-mail:htk54@ zentuuji.hosp.go.jp). 1Department of Surgery, National Hospital Organization Zentsuji National Hospital, Japan; Department of 2Surgery, 3lnternal Medicine, Tokushima Municipal Hospital, Japan. Reprints: Shigeki Hatakeyama, Department of Surgery, National Hospital Organization Zentsuji National Hospital, 2-1-1 Senyu-cho, Zentsuji, Kagawa 765-8507, Japan (e-mail: htk54@zentuuji.hosp.go. jp). Received January 28, 2004; accepted April 19, 2004. (C) 2004 The Japan Lung Cancer Society Japanese Journal of Lung Cancer—Vol44, No3, Jun 20, 2004—www.haigan.gr.jp 173 Helicobacter pylori Infection in Patient With Lung Cancer and ITP-Hatakeyama et al standard therapy for DIC, but following a combination of chemotherapy and monthly platelet transfusions her condition improved. Because she was treated with chemotherapy, platelet transfusions were required. Re-evaluation of thrombocytopenia showed normal FDP levels, and ITP was diagnosed because of elevated levels of PAIgG. Urea breath test showed Helicobacter pylori infection at the end of June. Eradication therapy for Helicobacter pylori let to a recovery in platelet count. Conclusion. Helicobacter pylori is hypothesized to be causally related with ITP associated lung cancer in addition to cancer associated DIC and myelosuppression due to chemotherapy. (JJLC. 2004;44:173-177) KEY WORDS-Thrombocytopenia, Lung cancer, Idiopathic thrombocytopenic purpura (ITP), Helicobacter pylori

haigan

A Case of Lung Cancer With Idiopathic Thrombocytopenic Purpura Caused by Helicobacter Pylori-Improvement of Thrombocytopenia After Treatment for Helicobacter pylori-