RESUMO
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.
Assuntos
Plaquetas/efeitos dos fármacos , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Púrpura Trombocitopênica Idiopática/complicações , Púrpura Trombocitopênica Idiopática/microbiologia , Adolescente , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Antiulcerosos/uso terapêutico , Criança , Doença Crônica , Claritromicina/uso terapêutico , Feminino , Helicobacter pylori , Humanos , Masculino , Omeprazol/uso terapêutico , Contagem de PlaquetasAssuntos
Infecções por Acinetobacter/tratamento farmacológico , Acinetobacter calcoaceticus , Anti-Infecciosos/administração & dosagem , Ciprofloxacina/administração & dosagem , Leucemia Mieloide Aguda/complicações , Infecções por Acinetobacter/diagnóstico por imagem , Infecções por Acinetobacter/microbiologia , Técnicas de Tipagem Bacteriana , Cateterismo Venoso Central/efeitos adversos , Criança , Contaminação de Equipamentos , Humanos , Leucemia Mieloide Aguda/diagnóstico por imagem , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/microbiologia , Pulmão/diagnóstico por imagem , Pulmão/microbiologia , Masculino , Micoses/etiologia , Micoses/microbiologia , Baço/diagnóstico por imagem , Baço/microbiologia , Tomografia Computadorizada por Raios X/métodosRESUMO
Recently, an association between Helicobacter pylori (HP) and iron deficiency anemia (IDA) was proposed. We describe 9 pediatric patients with a history of long-standing IDA and HP infection. After HP test results were confirmed to be positive, anti-HP therapy consisting of omeprazole, clarithromycin, and amoxicillin was administered for 2 weeks. The hematologic profile and iron status were assessed before and periodically after the end of the eradication regimen. The eradication of HP was associated with stable normalization of iron stores. HP infection may be involved in cases of IDA of unknown origin, and the eradication of HP is associated with the resolution of anemia.
