Case 1: A 78-year-old woman was diagnosed with H. pylori positive
gastritis at a previous hospital in April 2012 and received 3rd-line H. pylori eradication
therapy, which ended in failure. She was referred to our department due to
oral hemorrhage,
petechiae involving all four extremities, and
thrombocytopenia in January 2016. She was hospitalized with a diagnosis of
ITP and received inpatient treatment. While receiving outpatient
prednisolone (PSL) treatment, we administered 4th-line eradication
therapy in March. Her platelet levels have since returned to normal, and PSL treatment has been discontinued. She is currently followed without treatment. Case 2: A 65-year-old woman was diagnosed with
ITP at a previous hospital in June 2013 and received 2nd-line eradication
therapy, which ended in failure. Thereafter, PSL treatment was continued but she was later referred to our department in March 2016. Since 3rd-line eradication
therapy was successful, her platelet count normalized and PSL treatment has been discontinued. She is currently followed without treatment. Based on our observations in these two cases, third-line H. pylori eradication
therapy is potentially effective in
ITP patients.