title: Relapse of idiopathic thrombocytopenic purpura caused by influenza A virus infection: a case report.
abstract: We report a patient with idiopathic thrombocytopenic purpura (ITP) in remission, who relapsed as a result of an influenza A virus infection. A 41-year-old woman presented with fever elevation, coughing, and generalized petechiae. Her platelet count had decreased to 1 x 10(9)/l. She had been diagnosed with ITP at age 23, and continuous complete remission had followed steroid therapy and splenectomy. Influenza A antigen was positive in her pharyngeal aspirate, and oseltamivir was effective for her symptoms. Findings of a bone marrow smear were typical for ITP. Steroid therapy resulted in a second complete remission. Although the development of ITP caused by influenza infection and a relapse caused by an influenza vaccination have been previously described, a relapse caused by a sporadic infection has never been documented to our knowledge. Physicians should carefully monitor the hematological data of influenza patients, especially those with ITP, even in remission.
authors.affiliation: Department of Hematology, Aiseikai Yamashina Hospital, 19-4 Takehana Shichouno-cho, Yamashina-ku, Kyoto 607-8086, Japan. aiseikai@mbox.kyoto-inet.or.jp
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kaneko
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohkawara
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nomura
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horiike
authors.forename: Masafumi
authors.initials: M
authors.lastname: Taniwaki
mesh_terms: D000328:Adult; D001774:Blood Chemical Analysis; D001853:Bone Marrow; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications*; D011696:Purpura, Thrombocytopenic / Q000175:diagnosis* / Q000209:etiology; D012008:Recurrence