title: Severe thrombocytopenia as a complication of acute Epstein-Barr virus infection.
abstract: Severe thrombocytopenia is an extremely rare complication of acute Epstein-Barr virus (EBV) infection. EBV infection usually causes hematological abnormalities, mainly atypical lymphocytosis, which is a feature of infectious mononucleosis, and uncomplicated cases often present with mild decreases in platelet counts. Our otherwise healthy, 21-year-old male Caucasian patient had thrombocytopenia and bleeding diathesis with platelet counts of 8 x 10(9)/L without other signs and symptoms of infectious mononucleosis. We commenced treatment with intravenous methylprednisolone before the acute EBV infection was serologically confirmed. Platelet counts initially rose and then fell after we stopped administrating corticosteroids. Repeated administration of methylprednisolone was followed by full recovery of the platelet count and normalization of formerly elevated transaminases. EBV infection may happen in children, adolescents and adults and this differential diagnosis should be considered in every patient presenting with acute thrombocytopenia.
authors.affiliation: Department of Internal Medicine, Unit of Nephrology and Hypertension, University Hospital Center Rebro, Zagreb, Croatia. RobertLikic@inet.hr
authors.forename: Robert
authors.initials: R
authors.lastname: Likic
authors.forename: Dusko
authors.initials: D
authors.lastname: Kuzmanic
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006474:Hemorrhagic Disorders / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007244:Infectious Mononucleosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D007262:Infusions, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009853:Omeprazole / Q000627:therapeutic use; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000209:etiology*; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000897:Anti-Ulcer Agents; D007166:Immunosuppressive Agents; D009853:Omeprazole; D008775:Methylprednisolone