Evaluation of Thrombocytopenia related to excessive use of Proton Pump Inhibitors.

Fizza Faheem, Hafiza Ushna Abbas, Maria Aslam

Abstract


Objective: The main aim of this study was to evaluate the thrombocytopenia related to excessive use of proton pump inhibitors.

Place and Duration of Study: This study was carried out in a duration of 7 month from March 2019 to September 2019 in Medical departments of Mayo Hospital Lahore.

Type of study: It is an observational study.

Materials and Methods: A total of 50 Patients were included in this study who were using proton pump inhibitors. Blood samples of all these patients were collected and the sent to a reliable laboratory for thrombocytes calculation. Duodenal ulcers was a common past medical problem in all these patients. All the patients had already used NSAIDS. Data was collected on a predesigned proforma. Informed consent was taken from all the patients. Ethical committee approval was taken.

Results: Data analysis was done of these 50 patients which showed that neutrophils and white blood cells have a slight decreasing trend. As patients were using no other drug except a single dose of heparin which was given prophylactically which could be the cause of thrombocytopenia, it was advised to stop the proton pump inhibitor. Within two days of holding the drug platelet count increased to 99 x 103/mm3. Nonspecific gastritis was seen on upper GI endoscopy done at that time. H. pylori infections were found to be negative on biopsies.

Conclusion: From our study it was found that proton pump inhibitors could be the cause of thrombocytopenia.


Keywords


Proton pump inhibitors, general population, thrombocytopenia

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References


Komazawa Y, Adachi K, Mihara T, et al.Tolerance to famotidine and ranitidine treatment after 14 days of administration in healthy subjects without Helicobacter pylori infection. J Gastroenterol Hepatol. 2003;18:678–682.

Iwakiri K, Kinoshita Y, Habu Y, et al. Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015. J Gastroenterol. 2016;51:751–767.

Lanas A. We are using too many PPIs, and we need to stop: a European perspective. Am J Gastroenterol. 2016;111:1085–1086.

Fujisawa T, Adachi K, Komazawa Y, et al. Helicobacter pylori infection prevents the occurrence of the tolerance phenomenon of histamine H2 receptor antagonists. Aliment Pharmacol Ther. 2004;20:559–565.

Adachi K, Komazawa Y, Mihara T, et al. Comparative study of the speed of acidsuppressing effects of oral administration of cimetidine and famotidine. J GastroenterolHepatol. 2005;20:1012–1015.

Shin JM, Inatomi N, Munson K, et al. Characterization of a novel potassiumcompetitive acid blocker of the gastric H,K-ATPase, 1-[5-(2-fluorophenyl)-1- (pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl]-Nmethylmethanamine monofumarate (TAK- 438) J Pharmacol Exp Ther. 2011;339:412–420.

Scott DR, Munson KB, Marcus EA, Lambrecht NW, Sachs G. The binding selectivity of vonoprazan (TAK-438) to the gastric H+, K+-ATPase. Aliment Pharmacol Ther. 2015;42:1315–1326.

Sakurai Y, Nishimura A, Kennedy G, et al. Safety, Tolerability, pharmacokinetics, and pharmacodynamics of single rising TAK- 438 (vonoprazan) doses in healthy male Japanese/non-Japanese subjects. Clin Transl Gastroenterol. 2015;6:e94.

Sakurai Y, Mori Y, Okamoto H, et al. Acid-inhibitory effects of vonoprazan 20 mg compared with esomeprazole 20 mg or rabeprazole 10 mg in healthy adult male subjects--a randomised open-label crossover study. Aliment PharmacolTher. 2015;42:719–730.

Ashida K, Sakurai Y, Hori T, et al. Randomised clinical trial: vonoprazan, a novel potassium competitive acid blocker, vs. lansoprazole for the healing of erosive oesophagitis. Aliment Pharmacol Ther. 2016;43:240–251.

Murakami K, Sakurai Y, Shiino M, Funao N, Nishimura A, Asaka M. Vonoprazan, a novel potassium-competitive acid blocker, as a component of first-line and secondline triple therapy for Helicobacter pylori eradication: a phase III, randomised, double-blind study. Gut. 2016;65:1439–1446.

Kahrilas PJ, Dent J, Lauritsen K, et al. A randomized, comparative study of three doses of AZD0865 and esomeprazole for healing of reflux esophagitis. Clin Gastroenterol Hepatol. 2007;5:1385–1391.

Dent J, Kahrilas PJ, Hatlebakk J, et al. A randomized, comparative trial of a potassium-competitive acid blocker (AZD0865) and esomeprazole for the treatment of patients with nonerosive reflux disease. Am J Gastroenterol. 2008;103:20–26.

Shirai N, Furuta T, Moriyama Y, et al. Effects of CYP2C19 genotypic differences in the metabolism of omeprazole and rabeprazole on intragastric pH. Aliment Pharmacol Ther. 2001;15:1929–1937.


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