Department of Internal Medicine, St. Barnabas Hospital Bronx , Bronx, NY , USA.
Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
Front Med (Lausanne). 2015 Nov 3;2:79. doi: 10.3389/fmed.2015.00079. eCollection 2015.
Immune thrombocytopenic purpura (ITP) is defined as an acquired thrombocytopenia with antibodies detected against platelet surface antigens, and it is the most common form of thrombocytopenia in otherwise asymptomatic adults. ITP secondary to an underlying condition is a diagnosis of exclusion that is essential to establish for treatment efficacy. Secondary thrombocytopenia caused by cytomegalovirus (CMV) is common; however, case reports associated with diagnosis in immunocompetent adults are rare, and to the best of our knowledge only 20 publications have been associated with this diagnosis. Our report is based on a clinical presentation of a 37-year-old female complaining of petechiae, heavy menses, shortness of breath, and a platelet count of 1 × 10(9)/L. Treatment with IVIG and steroids failed to improve platelet count. Subsequently, an infectious laboratory workup was performed, detecting CMV infection, and treatment with antiviral agents was initiated, causing platelet count to increase as viral load decreased.
免疫性血小板减少性紫癜(ITP)定义为一种获得性血小板减少症,伴有针对血小板表面抗原的抗体,是无症状成人中最常见的血小板减少症形式。继发于潜在疾病的 ITP 需要排除诊断,这对治疗效果至关重要。继发于巨细胞病毒(CMV)的血小板减少症很常见;然而,与免疫功能正常的成年人相关的诊断病例报告很少,据我们所知,仅有 20 篇文献与该诊断相关。我们的报告基于一名 37 岁女性的临床表现,她主诉出现瘀点、月经过多、呼吸急促和血小板计数为 1×10(9)/L。静脉注射免疫球蛋白和类固醇治疗未能提高血小板计数。随后,进行了传染病实验室检查,检测到 CMV 感染,并开始使用抗病毒药物治疗,随着病毒载量的降低,血小板计数增加。