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[Thrombocytopenia in cytomegalovirus infection]
1Paediatrisk afdeling, Kolding Sygehus.
Insights
Cytomegalovirus (CMV) infection can cause thrombocytopenic purpura in infants. Intravenous immunoglobulin provided temporary improvement, with spontaneous recovery occurring after ten months in one case.
Area of Science:
- Pediatrics
- Virology
- Hematology
Background:
- Postnatally acquired Cytomegalovirus (CMV) infection is a rare cause of severe thrombocytopenic purpura in infants.
- Thrombocytopenia, a condition characterized by low platelet counts, can lead to serious bleeding complications.
Observation:
- A 15-month-old female presented with thrombocytopenic purpura secondary to CMV infection.
- Initial treatment with intravenous immunoglobulin (IVIG) resulted in a transient increase in platelet count.
- The patient experienced spontaneous recovery of platelet levels after a ten-month period.
Findings:
- Literature review up to 1993 identified only five prior cases of severe thrombocytopenia due to CMV in otherwise healthy individuals.
- Prednisone treatment in four adult cases showed no significant effect on platelet counts.
- Repeated IVIG infusions were effective in managing persistent severe thrombocytopenia in a one-year-old child.
Implications:
- This case highlights the potential for CMV infection to induce significant thrombocytopenia in infants.
- Intravenous immunoglobulin may offer temporary benefits, but spontaneous recovery is also possible.
- Further research is needed to establish optimal treatment strategies for CMV-induced thrombocytopenia in pediatric populations.
Abstract:
A case of a 15 month old female patient with thrombocytopenic purpura induced by postnatally acquired Cytomegalovirus (CMV) infection is described. Treatment with intravenous immunoglobulin caused a satisfactory but short-lived attainment of normal platelet count. Spontaneous recovery took place after ten months. A review of the literature up to 1993 revealed that medical treatment of severe thrombocytopenia in normal hosts with the same aetiology had been reported in only five cases, Prednisone treatment was given in four cases (all adults), with no apparent effect on platelet count. Persistent severe thrombocytopenia in a one-year-old child responded to repeated intravenous infusions of immunoglobulin.