From the Research
Yes, Helicobacter pylori infection can result in chronic leukocytosis. H. pylori is a bacterium that colonizes the stomach and causes chronic inflammation of the gastric mucosa. This persistent inflammatory response can trigger an increase in white blood cell production, leading to leukocytosis (elevated white blood cell count) that may persist as long as the infection remains active.
Key Points
- The body produces more white blood cells, particularly neutrophils, as part of the immune response to combat the bacterial infection.
- This inflammatory response involves the release of cytokines and other inflammatory mediators that stimulate bone marrow to increase white blood cell production.
- A study from 1996 1 found that the total number of blood leukocytes and the numbers of lymphocytes and basophils were significantly increased in H. pylori-positive patients.
- Treatment of H. pylori typically involves a combination therapy known as triple therapy, which includes two antibiotics (commonly amoxicillin 1g twice daily and clarithromycin 500mg twice daily) plus a proton pump inhibitor (such as omeprazole 20mg twice daily) for 10-14 days.
- Successful eradication of H. pylori infection usually results in normalization of white blood cell counts within several weeks as the inflammatory stimulus is removed, as supported by recent guidelines 2, 3, 4.
- If leukocytosis persists after successful H. pylori treatment, other causes should be investigated.
Recent Guidelines
Recent guidelines from 2021 3, 4 recommend quadruple therapies (bismuth quadruple and concomitant) as the first-line treatment for H. pylori infection, with a 14-day clarithromycin-containing triple therapy suggested in areas with low prevalence of clarithromycin resistance and in patients without previous use of macrolides.
Treatment
The choice of H. pylori eradication regimen should be based on the local prevalence of clarithromycin resistance and the previous use of macrolides. Second-line treatments include levofloxacin-containing triple therapy and bismuth quadruple therapy. Probiotic supplementation should be used with the aim to reduce antibiotic-related adverse events. Recent evidence would support current guideline recommendations for the treatment of Helicobacter pylori infection 4.