Background and Aims: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune blood disorder with a characteristic purpuric rash and thrombocytopenia. The disease can progress into chronic ITP when steroid treatment fails. A quarter of patients who had splenectomy due to chronic ITP may continue to have thrombocytopenia. In these cases, it is thought that testing positive for H. pylori may be perpetuating thrombocytopenia. Methods: We investigated the presence of H. pylori infection in patients with chronic ITP who are either responsive or refractory to splenectomy using invasive GI endoscopy followed by rapid urease test. Results: We report that chronic ITP patients who were refractory to splenectomy had improved platelet counts following the eradication of H. pylori Conclusions: We suggest screening for H. pylori in patients with chronic ITP refractory to splenectomy. Treatment of H. pylori can increase the response to splenectomy as judged by the increased platelet counts.
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