IMMUNE THROMBOCYTOPENIC PURPURAAND ITS ASSOCIATION WITH HELICOBACTER PYLORI INFECTION

Introduction: The relationship between H.pylori infection and ITPwas initially described in 1998 in an Italian study. According to the Maastricht III consensus conference ITP is one of the two extra-intestinal diseases for which H.pylori infection and eradication is indicated. We have determined the frequency of H.pylori infection in ITP patients to ascertain significant association with H.pylori. The prevalence of H.pylori infection and its association with ITP was studied in a series of 50 ITP patients on regular follow up in the Hematology department in RGGGH. They were subjected to endoscopy. Antral biopsy was taken and rapid urease test was performed to confirm the H.pylori status of the patients. Aim : To study the association between Immune Thrombocytopenic Purpura and Helicobacter pylori infection. To determine the prevalence of Helicobacter pylori infection in Indian patients with ITP. To evaluate if H. Pylori infected patients with ITP could be identified by symptoms referable to the GI tract. To study the clinical profile of ITP patients. Results : 18 of the 50 ITP patients (36%) were found to be H.pylori positive. The p value was calculated using the 't' test which was found to be 0.048 which shows significant association of H.pylori infection with ITP. Hence all ITP patients should be screened for H.pylori and steps to eradicate H.pylori must be undertaken. Bacterium eradication provides a new good option for a non-immunosuppressive treatment in some ITP patients. Conclusion : The present study confirms the existence of association between H.pylori and ITP(P< 0.05). Our study also showed a significant association between the platelet counts at presentation in H.pylori positive ITP patients. There was no significant association with other parameters like sex, age, residence, socioeconomic status, bleeding, dyspepsia and endoscopy findings. Considering the low costs and non-invasiveness of the diagnostic test and the favorable toxicity profile of eradication compared to the standard treatment for ITPthe detection and eradication of H.pylori should be considered in high prevalent areas.