Autoimmune thrombocytopenic purpura and Helicobacter pylori infection
Autoimmune thrombocytopenic purpura and Helicobacter pylori infection
复制标题
DOI：
10.1001/archinte.162.9.1033
复制
发表时间：
2002-05-13
影响因子：
--
通讯作者：
Bierling, P
中科院分区：
文献类型：
--
作者：
Michel, M;Khellaf, M;Bierling, P
背景：对于自身免疫性血小板减少性紫癜（AITP）中触发血小板自身抗体产生的机制知之甚少。最近，据报道，通过标准抗生素治疗方案根除幽门螺杆菌后，AITP 并发幽门螺杆菌感染患者的血小板计数显着改善。我们在成人中寻找幽门螺杆菌感染与 AITP 之间的关联。方法：纳入了 51 名法国白人成人，人类免疫缺陷病毒阴性（平均值+/-SD），年龄（40+/-19.8 岁），患有 AITP，发病时血小板计数低于 50 X 10(3)/μL。 35 名连续的非血小板减少症患者（平均+/-标准差，年龄，43+/-22 岁）相同来源且幽门螺杆菌状态未知的患者作为对照受试者。通过凝集法在患者和对照受试者中检测到幽门螺杆菌抗体。比较幽门螺杆菌阴性和幽门螺杆菌阳性 AITP 患者的性别比、平均年龄、出血表现、皮质类固醇治疗反应和最终结果。为了测试可能的分子模拟机制，我们还使用免疫印迹测定法在 3 名幽门螺杆菌阳性 AITP 患者的血小板洗脱物中寻找特异性幽门螺杆菌抗体。 结果：AITP 患者中幽门螺杆菌的血清阳性率 (15 [29%]) 与对照受试者 (10 [29%]) 没有显着差异。幽门螺杆菌阳性和幽门螺杆菌阴性的AITP患者在AITP发病时的主要特征、对皮质类固醇的反应率和最终结果方面没有差异。所调查的 3 名患者中，血小板洗脱液中均未检测到幽门螺杆菌抗体。结论：虽然不能排除幽门螺杆菌在 AITP 患者亚组中的作用，但我们没有发现幽门螺杆菌感染与 AITP 之间存在关联的证据。
Background: The mechanisms triggering the production of platelet autoantibodies in autoimmune thrombocytopenic purpura (AITP) are poorly understood. Recently, marked improvements in platelet counts have been reported in patients with AITP and concurrent Helicobacter pylori infection after eradication of H pylori by a standard antibiotic regimen. We looked for an association between H pylori infection and AITP in adults.Methods: Fifty-one adults of white French origin, negative for human immunodeficiency virus (mean+/-SD) age, 40+/-19.8 years), with AITP and a platelet count of less than 50 X 10(3)/muL at onset were included. Thirty-five consecutive nonthrombocytopenic patients (mean+/-SD) age, 43+/-22 years) of the same origin and with unknown H pylori status served as control subjects. Antibodies against H pylori were detected by means of an agglutination method in both patients and control subjects. Sex ratio, mean age, hemorrhagic manifestations, response to corticosteroid therapy, and final outcome were compared in H pylori-negative and H pylori-positive patients with AITP. To test for a possible molecular mimicry mechanism, we also used an immunoblot assay to look for specific H pylori antibodies in platelet eluates from 3 H pylori-positive patients with AITP.Results: Seroprevalence of H pylori in patients with AITP (15 [29%]) was not significatively different from that in control subjects (10 [29%]). The H pylori-positive and H pylori-negative patients with AITP did not differ in main characteristics at AITP onset, response rate to corticosteroids, and final outcome. None of the 3 patients investigated had H pylori antibodies in platelet eluates.Conclusion: Although the role of H pylori in a subgroup of patients with AITP cannot be excluded, we found no evidence of an association between H pylori infection and AITP.