Correspondence Address:
Dr. Antonio Ponzetto
Department of Medical Sciences, University of Torino, Corso AM Dogliotti 14, Torino -10126
Italy

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Dear Sir,

We found of interest the clinical case of thrombotic thrombocytopenic purpura (TTP) during pregnancy presented by Basta.[1] He reports of a 39-year-old lady who had had previous episodes of TTP correlated with pregnancy; therefore, a presumptive diagnosis of acquired TTP was made. We would like to stress the correlation between TTP and infection by Helicobacter pylori, in particular when it belongs to the so-called pathogenic strain, which is characterized by the synthesis of the cytotoxin-associated gene A protein (CagA).[2] The cure of this bacterium was followed by regression of TTP.[3] In the case reported by Basta, the lady's previous pregnancy was complicated by pre-eclampsia (PE), another ailment strongly associated with infection by Helicobacter pylori: we observed that in Turin, Italy, 90.6% of preeclamptic women giving birth to small-for-gestational age newborns were infected by CagA positive strains of the bacterium, compared to 22.4% of uneventful pregnancies (odds ratio, 17.66).[4] Several other reports confirmed our findings.[5] We believe that the prudent physician should search for the infection by pathogenic strains of H. pylori prior to every pregnancy.

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