Chraïbi Samy, Najioullah Fatiha, Bourdin Carole, Pegliasco Jean, Deligny Christophe, Résière Dabor, Meniane Jean-Côme
Clinical Hematology Department, University Hospital of Martinique, Martinique, France.
Virology Laboratory, University Hospital of Martinique, Martinique, France.
J Clin Virol. 2016 Oct;83:61-2. doi: 10.1016/j.jcv.2016.08.299. Epub 2016 Aug 31.
We report here two cases of thrombocytopenic purpura at onset of Zika virus infection. A 26-year-old woman and a 21-year-old man had thrombocytopenia above 5×10(9) platelets/L. Hemorrhagic symptoms were mucosal and subcutaneous bleeding and gross hematuria and they reported episode of conjunctivitis. In both cases blood and bone marrow analysis suggested thrombocytopenic purpura, blood PCR tests for Dengue (DENV), Chikungunya (CHIKV) and Zika virus (ZIKV) were negative. In both cases urinary PCR for ZIKV was positive, Prednisolone yielded early remission. Only three similar cases have been reported so far. In the Caribbean, DENV is also epidemic and responsible for severe thrombocytopenia. Coinfections can occur. Our report underlines the need to include a ZIKV assay in the diagnostic work-up of thrombocytopenic purpura in epidemic areas.
我们在此报告两例寨卡病毒感染初期出现血小板减少性紫癜的病例。一名26岁女性和一名21岁男性的血小板计数低于5×10⁹/L。出血症状为黏膜和皮下出血以及肉眼血尿，他们还报告有结膜炎发作。两例患者的血液和骨髓分析均提示血小板减少性紫癜，登革热（DENV）、基孔肯雅热（CHIKV）和寨卡病毒（ZIKV）的血液PCR检测均为阴性。两例患者的尿液ZIKV PCR检测均为阳性，泼尼松龙治疗后早期缓解。迄今为止，仅报告了三例类似病例。在加勒比地区，DENV也呈流行状态，并可导致严重血小板减少。可能会发生合并感染。我们的报告强调，在流行地区血小板减少性紫癜的诊断检查中需要进行ZIKV检测。
