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Blood, 5 February 2009, Vol. 113, No. 6, pp. 1231-1240. Prepublished online as a Blood First Edition Paper on October 22, 2008; DOI 10.1182/blood-2008-07-167155. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-07-167155v1 113/6/1231    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Stasi, R. Articles by Bussel, J. B. Search for Related Content PubMed PubMed Citation Articles by Stasi, R. Articles by Bussel, J. B. Related Collections Free Research Articles Platelets and Thrombopoiesis Clinical Trials and Observations Related Articles in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Effects of eradication of Helicobacter pylori infection in patients with immune thrombocytopenic purpura: a systematic review Roberto Stasi1, Ameet Sarpatwari2, Jodi B. Segal3, John Osborn4, Maria Laura Evangelista1, Nichola Cooper5, Drew Provan6, Adrian Newland6, Sergio Amadori7, and James B. Bussel8 1 Department of Medical Sciences, Ospedale Regina Apostolorum, Albano Laziale, Italy; 2 Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; 3 Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD; 4 Department of Public Health Science, University of Rome La Sapienza, Rome, Italy; 5 Molecular Immunology Unit, Institute of Child Health, London, United Kingdom; 6 Department of Haematology, Barts and The London School of Medicine and Dentistry, London, United Kingdom; 7 Department of Hematology, Tor Vergata University Hospital, Rome, Italy; and 8 Department of Pediatrics, Division of Hematology/Oncology, Weill Medical College of Cornell University, New York–Presbyterian Hospital, NY Whether the eradication of Helicobacter pylori infection can increase the platelet count in patients with immune thrombocytopenic purpura (ITP) is still a controversial issue. To provide evidence-based guidance, we performed a systematic review of the literature published in English, selecting articles reporting 15 or more total patients. We identified 25 studies including 1555 patients, of whom 696 were evaluable for the effects of H pylori eradication on platelet count. The weighted mean complete response (platelet count 100 x 109/L) and overall response (platelet count 30 x 109/L and at least doubling of the basal count) were 42.7% (95% confidence interval [CI], 31.8%-53.9%) and 50.3% (95% CI, 41.6%-59.0%), respectively. In 222 patients with a baseline platelet count less than 30 x 109/L, the complete response rate was 20.1% (95% CI, 13.5%-26.7%) and the overall response rate was 35.2% (95% CI, 28.0%-42.4%). The response rate tended to be higher in countries with a high background prevalence of H pylori infection and in patients with milder degrees of thrombocytopenia. These findings suggest that the detection and eradication of H pylori infection should be considered in the work-up of patients with seemingly typical ITP. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Articles in Blood Online: A case of apples and pears? Mark Crowther, Mark A. Vickers, and Alison Avenell Blood 2009 113: 6259-6260. [Full Text] [PDF] Response: A case of rich fruit Ameet Sarpatwari, Jodi B. Segal, James B. Bussel, Roberto Stasi, and John Osborn Blood 2009 113: 6260. [Full Text] [PDF] This article has been cited by other articles: L. Trinquart and E. Touze Pitfalls in Meta-Analysis of Observational Studies: Lessons From a Systematic Review of the Risks of Stenting for Intracranial Atherosclerosis Stroke, October 1, 2009; 40(10): e586 - e587. [Full Text] [PDF] D. B. Cines, J. B. Bussel, H. A. Liebman, and E. T. Luning Prak The ITP syndrome: pathogenic and clinical diversity Blood, June 25, 2009; 113(26): 6511 - 6521. [Abstract] [Full Text] [PDF] M. Crowther, M. A. Vickers, and A. Avenell A case of apples and pears? Blood, June 11, 2009; 113(24): 6259 - 6260. [Full Text] [PDF] A. Sarpatwari, J. B. Segal, J. B. Bussel, R. Stasi, and J. Osborn Response: A case of rich fruit Blood, June 11, 2009; 113(24): 6260 - 6260. [Full Text] [PDF] J. N. George Definition, diagnosis and treatment of immune thrombocytopenic purpura Haematologica, June 1, 2009; 94(6): 759 - 762. [Full Text] [PDF] D. M. Arnold, A. Bernotas, I. Nazi, R. Stasi, M. Kuwana, Y. Liu, J. G. Kelton, and M. A. Crowther Platelet count response to H. pylori treatment in patients with immune thrombocytopenic purpura with and without H. pylori infection: a systematic review Haematologica, June 1, 2009; 94(6): 850 - 856. [Abstract] [Full Text] [PDF]

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