Santambrogio Elisa, Orsucci Lorella
Unit of Hematology, Città della Salute e della Scienza, Turin, Italy -
Unit of Hematology, Città della Salute e della Scienza, Turin, Italy.
Minerva Gastroenterol Dietol. 2019 Sep;65(3):204-213. doi: 10.23736/S1121-421X.19.02580-7. Epub 2019 Apr 16.
Helicobacter pylori (H. pylori) is one of the most common worldwide infections, which can affect both adults and children. The prevalence of this bacterium is variable in different countries, depending on various hygienic and socioeconomic conditions and living customs. The major damaged tissues of the infection are in the upper gastrointestinal tract, causing gastritis, gastric and duodenal ulcer and gastrointestinal malignancy. Nevertheless, other disorders are associated with this pathogen, including several hematological diseases, such as iron deficiency anemia, immune thrombocytopenia and vitamin B12 deficiency. A huge of data in literature support these associations, enough to recognize them in the last Maastricht V/Florence Consensus Report by European Study Group. The pathogenic mechanisms underlying the linkage between H. pylori and these hematological disorders are not clearly identified, but certainly the good hematological response reaches after eradication therapy confirm a central role of the bacterium in this scenario. Instead, the pathogenic mechanisms of H. pylori infection, which lead to the occurrence of mucosa-associated lymphoid tissue (MALT) lymphoma are clearer and more consolidated; so much that nowadays eradication therapy alone represents the only treatment in this disorder, when localized and with a concomitant H. pylori infection. This review focuses on the hematologic diseases related to H. pylori, particularly on iron deficiency anemia, vitamin B12 deficiency, immune thrombocytopenia and gastric MALT lymphoma.
幽门螺杆菌(H. pylori)是全球最常见的感染之一,可影响成人和儿童。该细菌的流行率在不同国家有所不同,取决于各种卫生和社会经济条件以及生活习惯。感染的主要受损组织在上消化道,可导致胃炎、胃和十二指肠溃疡以及胃肠道恶性肿瘤。然而,其他疾病也与这种病原体有关,包括几种血液系统疾病,如缺铁性贫血、免疫性血小板减少症和维生素B12缺乏症。文献中的大量数据支持这些关联,足以使其在欧洲研究小组的最新马斯特里赫特V/佛罗伦萨共识报告中得到认可。幽门螺杆菌与这些血液系统疾病之间联系的致病机制尚未明确,但根除治疗后良好的血液学反应肯定证实了该细菌在这种情况下的核心作用。相反,幽门螺杆菌感染导致黏膜相关淋巴组织(MALT)淋巴瘤发生的致病机制更清晰、更确凿;以至于如今,对于局限性且伴有幽门螺杆菌感染的这种疾病,单独的根除治疗是唯一的治疗方法。本综述重点关注与幽门螺杆菌相关的血液系统疾病,特别是缺铁性贫血、维生素B12缺乏症、免疫性血小板减少症和胃MALT淋巴瘤。