Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel.
Acta Paediatr. 2010 Sep;99(9):1385-8. doi: 10.1111/j.1651-2227.2010.01842.x.
The aim of the study was to characterize the clinical course of post-varicella idiopathic thrombocytopenic purpura (ITP) and to asses the risk of acquiring ITP after varicella infection.
A retrospective study of all children diagnosed with ITP in a tertiary medical centre during 1998-2008. Findings were compared with the Intercontinental Childhood ITP Study Group database. The risk of acquiring ITP after a varicella infection was assessed.
Ten children were diagnosed with post-varicella ITP. The incidence of post-varicella ITP was 1.9% amongst children diagnosed with ITP and 1.1% amongst children hospitalized for varicella. ITP was diagnosed, on average, 8.5 days after the onset of the varicella rash. The female-to-male ratio was 1:1.5. The average minimal platelet count was 9.5 × 10⁹ platelets/L. Post-varicella ITP had an acute course in 80% of cases and a chronic course in the remaining 20%. Bleeding episodes occurred in three patients. During the follow-up period, 11 patients with previously diagnosed ITP developed varicella. The infection had no apparent affect on the platelet count of the children with acute ITP, but caused a relapse in 71% of the patients with chronic ITP.
Post-varicella ITP has similar clinical features and course to non-varicella associated ITP. The calculated risk of ITP as a complication of varicella infections is approximately 1:25,000.
本研究旨在描述特发性血小板减少性紫癜（ITP）患儿在感染水痘后疾病的临床经过，并评估水痘感染后发生 ITP 的风险。
本研究为回顾性研究，纳入了 1998 年至 2008 年期间在一家三级医疗中心被诊断为 ITP 的所有患儿。研究结果与国际儿童 ITP 研究组数据库进行了比较。评估了水痘感染后发生 ITP 的风险。
10 例患儿被诊断为水痘后 ITP。在诊断为 ITP 的患儿中，水痘后 ITP 的发病率为 1.9%；在因水痘住院的患儿中，水痘后 ITP 的发病率为 1.1%。ITP 平均在水痘皮疹出现后 8.5 天被诊断。男女比例为 1:1.5。平均血小板计数最低为 9.5×10⁹ 个/L。80%的患儿为急性病程，20%的患儿为慢性病程。3 例患儿发生出血事件。在随访期间，11 例先前诊断为 ITP 的患儿发生了水痘感染。急性 ITP 患儿的感染对血小板计数无明显影响，但导致 71%的慢性 ITP 患儿复发。
水痘后 ITP 的临床特征和经过与非水痘相关 ITP 相似。水痘感染后发生 ITP 的风险约为 1:25000。
