CHRONIC IMMUNE THROMBOCYTOPENIA AND HELICOBACTER PYLORI INFECTION IN SUDANESE PATIENTS. -

Background/Aim: Immune thrombocytopenia (ITP) is an autoimmune disease mediated by anti-platelet auto-antibodies. There is growing evidence that the eradication of H. pylori effectively increases platelet count in a considerable proportion of H.pylori- infected ITP patients. The study aimed to determine sero-prevalence of H. pylori in chronic ITP patients and to compare the ITP characteristics in H.pylori infected and non-infected ITP patients. Patients/Method: the study was done on 60 already diagnosed ITP patients of at least 6|12 duration. On all patients were done Complete blood count (CBC), blood cells morphology (thin film), IgG for H.pylori antibodies and anti-platelet antibodies by ELISA. Anti-lewis antibodies were done by a serological method. All patients were screened for hepatitis B, C and HIV by ICT. The initial platelets count at diagnosis was obtained from the patients note and bone marrow examination performed by consultant hematologist. Their ages ranged between 2-74 years, there were 21 males and 39 females. 57 patients already were underwent corticosteroids treatment. Results: Anti H.pylori IgG, Anti-platelets, and anti-Lewis abs were detected in 63%, 58%, and 28%, respectively. There was a significant difference between platelets count at time of diagnosis and time of enrolling, P: < .00001. Moreover, a significant difference was found in platelets count at time of enrolling between H. pylori sero-positive and sero-negative ITP patients, P: 0.00006. In ITP treated patients (57/60) there was a significant rise in platelets count after compared to the initial count, P: 0.00001. In comparison of ITP characteristic between H.pylori sero-positive and sero-negative ITP patient; there was a significant difference in regard to anti-platelets antibodies status, P: 0.0001, platelets count at time of enrolling P: 0.00006, and corticosteroid response, P: 0.01. Conclusion: Anti -H.pylori and anti-platelets antibodies were frequent in ITP patients. Reduction in the platelet count was observed in H.pylori sero-positive ITP patients than sero-negative ones. In the majority of H.pylori sero-positive ITP patients; thrombocytopenia still persists even in those patients who underwent corticosteroids treatment - See more