Sugioka Takashi, Kubota Yasushi, Wakayama Kazuo, Kimura Shinya
Department of Community Medical Support Institute, Faculty of Medicine, Saga University, Japan.
Intern Med. 2012;51(13):1747-50. doi: 10.2169/internalmedicine.51.7193. Epub 2012 Jul 1.
Severe thrombocytopenia secondary to cytomegalovirus (CMV) infection is rare in immunocompetent hosts. We describe a case of severe thrombocytopenia secondary to CMV infection in an immunocompetent 30-year-old man who presented with pyrexia and bleeding tendency. A diagnosis of immune thrombocytopenia (ITP) was made following hematological and serological testing, and bone marrow aspiration. Acute CMV infection was confirmed by serological testing, antigenemia, and detection of CMV-DNA. Corticosteroid therapy was ineffective and intravenous immunoglobulin (IVIG) was therefore administered. This resulted in immediate recovery of the platelet count and cessation of nasal bleeding. Early IVIG administration should be considered in steroid-resistant cases.
巨细胞病毒（CMV）感染继发的严重血小板减少症在免疫功能正常的宿主中较为罕见。我们描述了一例30岁免疫功能正常男性因CMV感染继发严重血小板减少症的病例，该患者表现为发热和出血倾向。经过血液学和血清学检测以及骨髓穿刺后，诊断为免疫性血小板减少症（ITP）。通过血清学检测、抗原血症检测和CMV-DNA检测确诊为急性CMV感染。皮质类固醇治疗无效，因此给予静脉注射免疫球蛋白（IVIG）。这导致血小板计数立即恢复，鼻出血停止。对于激素抵抗的病例，应考虑早期给予IVIG。
