Investigating the link between Helicobacter pylori infection and idiopathic thrombocytopenic purpura a case-control...

Immune thrombocytopenic purpura (ITP) is an autoimmune disorder marked by isolated thrombocytopenia. Recent studies suggest a link between Helicobacter pylori (H. pylori) infection and ITP, possibly through molecular mimicry and immune-mediated mechanisms. This study aimed to investigate the association between H. pylori infection and ITP in a Pakistani population where both conditions are prevalent.

A case-control study was conducted from May 2022 to June 2024 at a tertiary care hospital in Pakistan. A total of 141 participants were enrolled, including 46 patients with primary ITP and 95 age- and sex-matched controls without thrombocytopenia. All subjects were tested for H. pylori using stool antigen tests, urea breath tests, and confirmatory biopsies where applicable. Logistic regression was used to assess the association while adjusting for potential confounders.

H. pylori infection was present in 39.1% of ITP patients compared to 17.9% of controls (P = 0.0026). The crude odds ratio (OR) was 2.96 (95% CI: 1.36-6.46), and the adjusted OR was 3.18 (95% CI: 1.42-7.13, P = 0.005) after controlling for age, gender, smoking, and socioeconomic status. Other variables were not significantly associated with ITP.

A significant association between H. pylori infection and ITP was observed, supporting the need for routine screening in ITP patients, especially in endemic areas. Further studies should evaluate the platelet response after H. pylori eradication and assess the role of bacterial strain variability.