[Helicobacter pylori-induced thrombocytopenia]

Abstract

Immune thrombocytopenic purpura (ITP) is a multicausal disease. In the majority of cases, autoimmune antibodies against thrombocytes and other autoimmune processes play a role. However, in about 20% of cases an underlying cause can be identified. Recently, Helicobacter pylori infection was recognized as one of these underlying causes. We present two patients with ITP in whom a significant increase of thrombocytes occurred after eradication of H. pylori. In the first patient, a 75-year-old man, experimental therapy was withheld. The second patient, a 47-year-old man, never received immunosuppressive medication. H. pylori screening and eradication should be standard practice in the work up of a patient with thrombocytopenia. Despite the lack of clear pathophysiological understanding, in a minority of ITP cases there is evidence of a correlation between H. pylori infection and ITP. Tests and treatment are non-invasive, cheap and without major side-effects. In the event of a platelet response, expensive immunosuppressive treatment with significant side effects may be avoided.