Large scale clinical and individual case studies discuss a potential relationship between the stomach infection, Helicobacter pylori, a major cause of stomach ulcers, gastritis and gastroesophageal reflux disease (GERD), and scleroderma.
Helicobacter pylori infection and systemic sclerosis-is there a link? Joint Bone Spine. 2011 Jul;78(4):337-40. doi: 10.1016/j.jbspin.2010.10.005. Epub 2010 Dec 8.
Croatian researchers hypothesize that systemic scleroderma pathogenesis may be the result of helicobacter pylori infection, the causative micro-organism of stomach ulcers, gastritis, and gastric cancer, after extensive review of literature in MEDLINE, EMBASE, Cochrane Library and ACR/EULAR meeting abstracts.
Is Helicobacter pylori infection a risk factor for disease severity in systemic sclerosis? Rheumatol Int. 2013 Nov;33(11):2943-8. doi: 10.1007/s00296-012-2585-z. Epub 2012 Dec 6.
Croatian researchers suspect Helicobacter pylori infection to be a trigger for systemic scleroderma and studied 46 scleroderma patients (SSc), 26 of whom tested positive for the infection. The authors state that there is a H. pylori infection prevalence of 62% in the SSc population and that disease severity was greater in these patients in terms of skin, gastrointestinal, and joint/tendon involvement. The authors further state that H. Pylori may play a role in SSc pathogenesis, thus providing prognostic information.
Helicobacter pylori in patients with systemic sclerosis: detection with the 13C-urea breath test and eradication. Acta Derm Venereol. 1994 Sep;74(5):361-3.
Researchers consider microbial gut overgrowth in systemic scleroderma (SSc) due to the gastric infection, Helicobacter pylori, resulting in delayed gastric emptying and peristaltic abnormalities. Five of twelve SSc patients in this study tested positive for the infection, raising the consideration that all SSc patients should be screened and treated appropriately, if infection is found.
Helicobacter pylori may be a common denominator associated with systemic and multiple sclerosis. Joint Bone Spine, 2011-03-01, Volume 78, Issue 2, Pages 222-223.
Researchers speculate that Helicobacter pylori may play a role in systemic scleroderma and multiple sclerosis, both of which cause sclerotic lesions; the former causing dermal and systemic scarring and the latter causing scarring of the myelin sheaths of nerves.
Reflux esophagitis and Helicobacter pylori infection in patients with scleroderma. Intern Med. 2008;47(18):1555-9. Epub 2008 Sep 16.
Japanese researchers studied 64 scleroderma patients, 37 (57.8%) of whom were positive for H. pylori infection. In spite of a lower incidence reflux esophagitis in the H. pylori-infected patients than H. pylori-negative patients, the authors state that their findings suggest an important role for H. Pylori infection in those with scleroderma and co-existent reflux esophagitis.
Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome concomitant with systemic sclerosis, immune thrombocytopenic purpura. Intern Med. 2009;48(23):2019-23. Epub 2009 Dec 1.
Japanese report of a 58-year-old woman, testing IgG-positive for Helicobacter pylori, and diagnosed with systemic scleroderma, immune thrombocytopenic purpura (ITP), autoimmune hepatitis and primary biliary cirrhosis. After 7 days of treatment with a combination of antibiotics, amoxicillin and clarithromycin, in addition to ursodeoxycholic acid, lansoprazole, and prednisolone, the patient’s platelets increased rapidly and liver enzymes improved.
Note: Although the case study authors do not draw a correlation to past infection with H. Pylori as a possible cause for the woman’s scleroderma with ITP overlap and liver disease, consideration of a possible association, in light of other independent studies that have drawn potential correlations, may be pertinent.