{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:32:43Z","timestamp":1786361563441,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Immune thrombocytopenic purpura (ITP) is an autoimmune disorder marked by isolated thrombocytopenia. Recent studies suggest a link between\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      ) infection and ITP, possibly through molecular mimicry and immune-mediated mechanisms. This study aimed to investigate the association between\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      infection and ITP in a Pakistani population where both conditions are prevalent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A case\u2013control 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\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      infection was present in 39.1% of ITP patients compared to 17.9% of controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =\u00a00.0026). The crude odds ratio (OR) was 2.96 (95% CI: 1.36\u20136.46), and the adjusted OR was 3.18 (95% CI: 1.42\u20137.13,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =\u00a00.005) after controlling for age, gender, smoking, and socioeconomic status. Other variables were not significantly associated with ITP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      A significant association between\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      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\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      eradication and assess the role of bacterial strain variability.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ms9.0000000000004331","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:00:09Z","timestamp":1764000009000},"page":"1225-1229","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Investigating the link between Helicobacter pylori infection and idiopathic thrombocytopenic purpura a case\u2013control study"],"prefix":"10.1097","volume":"88","author":[{"given":"Inayat","family":"Ullah","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Lady Reading Hospital, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Hamza","family":"Arshad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Wrightington Wigan and Leigh NHS Trust, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazhar","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Iftikhar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abid","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdur Rahman","family":"Qazi","sequence":"additional","affiliation":[{"name":"Department of Medicine, DHQ Teaching Hospital, Bannu, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lady Reading Hospital Peshawar, Peshawar, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zarak","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Blackpool Teaching Hospitals NHS Foundation Trust, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Bacha Khan Medical College, Mardan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sardar Noman","family":"Qayyum","sequence":"additional","affiliation":[{"name":"Department of Medicine, Bacha Khan Medical College, Mardan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Qadri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7332-5764","authenticated-orcid":false,"given":"Rafiullah","family":"Hotak","sequence":"additional","affiliation":[{"name":"Nangarhar University, Faculty of Medicine, Nangarhar, Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"R2-20260810","first-page":"59\u201361","article-title":"Immune thrombocytopenic purpura","volume":"9","author":"Zainal","year":"2019","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"R3-20260810","doi-asserted-by":"crossref","first-page":"91\u201396","DOI":"10.1046\/j.1365-2141.2003.04735.x","article-title":"Molecular mimicry by 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response to Helicobacter pylori eradication in Iranian patients with idiopathic thrombocytopenic purpura","volume":"4","author":"Payandeh","year":"2012","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"R9-20260810","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12878-018-0119-y","article-title":"The impact of helicobacter pylori eradication on platelet counts of adult patients with idiopathic thrombocytopenic purpura","volume":"18","author":"Aljarad","year":"2018","journal-title":"BMC Hematol"},{"key":"R10-20260810","doi-asserted-by":"crossref","first-page":"850\u201356","DOI":"10.3324\/haematol.2008.005348","article-title":"Platelet count response to H. pylori treatment in patients with immune thrombocytopenic purpura with and without H. pylori infection: a systematic review","volume":"94","author":"Arnold","year":"2009","journal-title":"Haematologica"},{"key":"R11-20260810","first-page":"6090878","article-title":"Helicobacter pylori eradication in idiopathic thrombocytopenic purpura: a meta-analysis of randomized trials","author":"Kim","year":"2018","journal-title":"Gastroenterol Res Pract"},{"key":"R12-20260810","doi-asserted-by":"crossref","first-page":"9370","DOI":"10.1038\/s41598-020-66460-5","article-title":"Helicobacter pylori eradication affects platelet count recovery in immune thrombocytopenia","volume":"10","author":"Lee","year":"2020","journal-title":"Sci Rep"},{"key":"R13-20260810","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s12876-023-02664-z","article-title":"Eradication therapy may decrease the risk of immune thrombocytopenia after Helicobacter pylori infection: a retrospective cohort study in Taiwan","volume":"23","author":"Koseki","year":"2023","journal-title":"BMC Gastroenterol"},{"key":"R14-20260810","doi-asserted-by":"crossref","first-page":"38\u201343","DOI":"10.5045\/br.2021.2020189","article-title":"Effect of Helicobacter pylori eradication on patients with ITP: a meta-analysis of studies conducted in the Middle East","volume":"56","author":"Pezeshki","year":"2021","journal-title":"Blood Res"},{"key":"R15-20260810","doi-asserted-by":"crossref","first-page":"4822","DOI":"10.3390\/jcm11164822","article-title":"Helicobacter pylori infection and chronic immune thrombocytopenia","volume":"11","author":"Takeuchi","year":"2022","journal-title":"J Clin Med"},{"key":"R16-20260810","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/MCG.0000000000001902","article-title":"The efficacy and safety of regimens for Helicobacter pylori eradication treatment in China: a systemic review and network meta-analysis","volume":"58","author":"Li","year":"2024","journal-title":"J Clin Gastroenterol"},{"key":"R18-20260810","doi-asserted-by":"crossref","first-page":"284\u2013303","DOI":"10.3934\/microbiol.2021018","article-title":"Helicobacter pylori induced immune thrombocytopenic purpura and perspective role of Helicobacter pylori eradication therapy for treating immune thrombocytopenic purpura","volume":"7","author":"Ihtesham","year":"2021","journal-title":"AIMS Microbiol"},{"key":"R19-20260810","doi-asserted-by":"crossref","first-page":"3829\u201366","DOI":"10.1182\/bloodadvances.2019000966","article-title":"American society of hematology 2019 guidelines for immune thrombocytopenia","volume":"3","author":"Neunert","year":"2019","journal-title":"Blood Adv"},{"key":"R20-20260810","doi-asserted-by":"crossref","first-page":"3833\u201341","DOI":"10.1182\/blood-2006-12-063222","article-title":"Helicobacter pylori infection and chronic immune thrombocytopenic purpura: long-term results of bacterium eradication and association with bacterium virulence profiles","volume":"110","author":"Emilia","year":"2007","journal-title":"Blood"},{"key":"R21-20260810","doi-asserted-by":"crossref","first-page":"227\u201330","DOI":"10.1080\/09537100500462487","article-title":"Helicobacter pylori eradication can induce platelet recovery in chronic idiopathic thrombocytopenic 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serum interleukin 6 among Helicobacter pylori-positive adult patients in relation to upper gastrointestinal endoscopy findings","volume":"22","author":"Omar","year":"2019","journal-title":"Suez Canal Univ Med J"},{"key":"R33-20260810","doi-asserted-by":"crossref","first-page":"1288\u2013300","DOI":"10.1161\/ATVBAHA.119.312129","article-title":"New insights into the differentiation of megakaryocytes from hematopoietic progenitors","volume":"39","author":"Noetzli","year":"2019","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"R34-20260810","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3390\/cells10010027","article-title":"Helicobacter pylori virulence factors\u2014mechanisms of bacterial pathogenicity in the gastric microenvironment","volume":"10","author":"Baj","year":"2020","journal-title":"Cells"}],"container-title":["Annals of Medicine &amp; 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History"}},{"value":"2025-11-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}