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Effect of eradication of Helicobacter pylori in children with chronic immune thrombocytopenia: A prospective, controlled, multicenter study
Author(s) -
Russo Giovanna,
Miraglia Vito,
Branciforte Francesca,
Matarese Sofia Maria Rosaria,
Zecca Marco,
Bisogno Gianni,
Parodi Emilia,
Amendola Giovanni,
Giordano Paola,
Jankovic Momcilo,
Corti Annalisa,
Nardi Margherita,
Farruggia Piero,
Battisti Laura,
Baronci Carlo,
Palazzi Giovanni,
Tucci Fabio,
Ceppi Stefania,
Nobili Bruno,
Ramenghi Ugo,
De Mattia Domenico,
Notarangelo Lucia
Publication year - 2011
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22770
Subject(s) - medicine , clarithromycin , helicobacter pylori , omeprazole , gastroenterology , amoxicillin , platelet , cohort , prospective cohort study , immune thrombocytopenia , immune system , immunology , antibiotics , microbiology and biotechnology , biology
Background The eradication of Helicobacter pylori has been associated with remission of immune thrombocytopenia (ITP) in approximately half of eradicated patients. Data on children are limited to small case series. Procedure Children from 16 centers in Italy, who were less than 18 years of age and diagnosed with chronic ITP (cITP), were screened for H. pylori infection. Positive patients underwent standard triple therapy with amoxicillin, clarithromycin, and omeprazole. The eradication response was defined as follows: complete response, platelet (PLT) count ≥150 × 10 9 /L; partial response, PLT count of at least 50 × 10 9 /L; no response, PLT count <50 × 10 9 /L. Results Of 244 screened patients, 50 (20%) had H. pylori infection, 37 of which received eradication therapy and completed follow‐up. Eradication was successful in 33/37 patients (89%). PLT recovery was demonstrated in 13/33 patients after eradication (39%), whereas spontaneous remission was observed in 17/166 (10%) H. pylori ‐negative patients ( P < 0.005). Responders more often required second line eradication (9/13), whereas a second cycle was required in 3/20 non‐responders ( P < 0.005). Conclusions Among the large cohort of patients, those who underwent successful H. pylori eradication showed a significantly higher PLT response. Therefore, it may be appropriate to look for H. pylori and eventually eradicate it in children with cITP. Pediatr Blood Cancer 2011;56:273–278. © 2010 Wiley‐Liss, Inc.