Platelet count response to Helicobacter pylori eradication for idiopathic thrombocytopenic purpura in northeastern Brazil.

BACKGROUND: Several studies have demonstrated that platelet counts in Helicobacter pylori-positive patients with chronic idiopathic thrombocytopenic purpura improved significantly after successful eradication of the infection. However, depending of the geographical region of the study the results have been highly divergent. OBJECTIVE: The purpose of this study was to evaluate the effect of H. pylori eradication therapy on platelet count in a cohort of chronic idiopathic thrombocytopenic purpura patients from northeastern Brazil. METHOD: H. pylori status was determined in 28 chronic idiopathic thrombocytopenic purpura patients using the rapid urease test and histology. H. pylori-positive patients received standard triple therapy for one week. The effect of the eradication therapy was evaluated using the 13C-urea breath test two to three months after treatment. RESULTS: The prevalence of H. pylori infection was similar to that found in the general population. Twenty-two patients (78.5%) were H. pylori-positive. Fifteen were treated, 13 (86%) of whom successfully. At six months, 4/13 (30%) displayed increased platelet counts, which remained throughout follow-up (12 months). Platelet response was not associated to mean baseline platelet count, duration of chronic idiopathic thrombocytopenic purpura, gender, age, previous use of medication, or splenectomy. CONCLUSIONS: H. pylori eradication therapy showed relatively low platelet recovery rates, comparable with previous studies from southeastern Brazil. The effect of H. pylori eradication on platelet counts remained after one year of follow-up suggesting that treating H. pylori infection might be worthwhile in a subset of chronic idiopathic thrombocytopenic purpura patients.

Platelet count response to Helicobacter pylori eradication for idiopathic thrombocytopenic purpura in northeastern Brazil

Abstract Background: Several studies have demonstrated that platelet counts in Helicobacter pylori-positive patients with chronic idiopathic thrombocytopenic purpura improved significantly after successful eradication of the infection. However, depending of the geographical region of the study the results have been highly divergent. Objective: The purpose of this study was to evaluate the effect of H. pylori eradication therapy on platelet count in a cohort of chronic idiopathic thrombocytopenic purpura patients from northeastern Brazil. Method: H. pylori status was determined in 28 chronic idiopathic thrombocytopenic purpura patients using the rapid urease test and histology. H. pylori-positive patients received standard triple therapy for one week. The effect of the eradication therapy was evaluated using the 13C-urea breath test two to three months after treatment. Results: The prevalence of H. pylori infection was similar to that found in the general population. Twenty-two patients (78.5%) were H. pylori-positive. Fifteen were treated, 13 (86%) of whom successfully. At six months, 4/13 (30%) displayed increased platelet counts, which remained throughout follow-up (12 months). Platelet response was not associated to mean baseline platelet count, duration of chronic idiopathic thrombocytopenic purpura, gender, age, previous use of medication, or splenectomy. Conclusions: H. pylori eradication therapy showed relatively low platelet recovery rates, comparable with previous studies from southeastern Brazil. The effect of H. pylori eradication on platelet counts remained after one year of follow-up suggesting that treating H. pylori infection might be worthwhile in a subset of chronic idiopathic thrombocytopenic purpura patients.

Serum type III procollagen peptides in patients with hepatointestinal and compensated hepatoesplenic schistosomiasis forms

Os níveis dos peptídios séricos do procolágeno tipo III (PSPC III) foram determinados em 35 indivíduos: 25 esquistossomóticos näo tratados da parasitose, sendo 16 da forma hepatointestinal (HI) e nove da hepatoesplênica compensada (HEC) e dez sadios. Para a dosagem dos PSPC III foram utilizados kits de radioimunoensaio. Procurou-se demonstrar a correlaçäo entre os níveis dos PSPC III e as atividades séricas das enzimas aminotransferase da alanina (ALT), aminotransferase do aspartato (AST), fosfatase alcalina (FA) e gamaglutamiltranspeptidase (GGTP). As médias dos valores dos PSPC III nas formas HI (13 ng/ml) e HEC (17 ng/ml) foram significantemente maiores do que as do grupo controle (9,0 ng/ml) (p < 0,05). Näo se observou diferença significante quanto aos valores dos PSPC III entre os grupos de pacientes das formas HI e HEC. Näo houve correlaçäo entre os aumentos dos PSPC III e os da atividade sérica da ALT, AST, FA e GGPT. Os autores discutem aspectos sobre eventual aplicabilidade da determinaçäo dos PSPC III em pacientes com esquistossomose

Serum type III procollagen peptides in patients with schistosomiasis mansoni before and after the treatment with oxamniquine

A fibrose pode ter importância significativa na hepatopatia esquistossomótica. O tratamento específico atual da esquistossomose pode proporcionar bons resultados, com regressäo de algumas alteraçöes hepáticas e, eventualmente, da fibrose. Os peptídios séricos dos procolágeno tipo III (PSPC III) poderiam, segundo alguns autores, estar correlacionados com o grau de fibrose, com a atividade fibrogênica, entre outros significados. A determinaçäo dos PSPCIII tem sido considerada útil no estudo evolutivo de algumas doenças hepáticas. Foram estudados 19 esquistossomóticos, 16 da forma clínica hepatointestinal (HI) e três da forma hepatoesplênica compensada (HEC) e um grupo controle, cosntituído de 10 indivíduos sadios. Os pacientes foram submetidos à avaliaçäo clínico-laboratorial antes e aproximadamente seis meses após o tratamento com oxamniquine. Para a dosagem dos PSPCIII, utilizaram-se kits de radioimunoensaio. Näo houve diferença estatisticamente significante quando se comapraram as médias dos valores séricos dos PSPCIII antes (13,6ng/ml e após (11,3ng/ml) o tratamento com oxamniquine. Os autores comentam a respeito das dificuldades para interpretaçäo dos resultados