Role of parvovirus B19 infection in childhood idiopathic thrombocytopenic purpura.
Although parvovirus B19 exhibits a strong tissue-tropism for erythroid progenitor cells leading to anaemia, several case reports indicate that parvovirus B19 infection may also cause the development of thrombocytopenia. Despite recent studies, the frequency and clinical relevance of this association have remained questionable. Consequently, and in view of the paucity of evidence regarding a viral aetiology for idiopathic thrombocytopenic purpura (ITP), we examined the role of parvovirus B19 in 47 children with newly diagnosed ITP. Specific viral DNA indicating a current or recent parvovirus B19 infection was demonstrated in 6 of 47 patients (13%) employing the polymerase chain reaction technique. Our study suggests that children with ITP and associated parvovirus B19 infection are characterized by acute onset of profound thrombocytopenia. Among the parvovirus B19 positive children, duration of disease was brief in three children treated with immunoglobulin but chronic in the remaining three patients given high-dose steroids. Prospective studies are needed to confirm these initial observations. This virus should be considered as a possible aetiologic agent in some children with ITP.
Department of Clinical Microbiology, University State Hospital, Rigshospitalet, Copenhagen, Denmark.
E D
ED
Heegaard
S
S
Rosthøj
B L
BL
Petersen
S
S
Nielsen
F
F
Karup Pedersen
A
A
Hornsleth
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000956:Antigens, Viral / Q000235:genetics; D001853:Bone Marrow / Q000502:physiology; D002648:Child; D002908:Chronic Disease; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005914:Globins / Q000235:genetics; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007150:Immunohistochemistry; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D010322:Parvoviridae Infections / Q000150:complications* / Q000235:genetics; D016732:Parvovirus B19, Human / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents; D000956:Antigens, Viral; D004279:DNA, Viral; D016756:Immunoglobulins, Intravenous; D005914:Globins; D008775:Methylprednisolone