Cytomegalovirus-induced thrombocytopenia in an immunocompetent adult effectively treated with intravenous immunoglobulin: a case report and review.
The authors report the case of an 80-year-old male patient who presented with colitis and severe thrombocytopenia. The work-up revealed concurrent cytomegalovirus infection. After failure of prednisone, a single infusion of high-dose intravenous immunoglobulin produced a rapid and sustained response. Seventeen cases from the world literature are reviewed. Corticosteroids seem effective in about one third of cases. In those who do not respond, splenectomy is relatively ineffective and more specific anti-CMV treatment with ganciclovir is of unproven efficacy and toxic, in view of the relatively favourable long term outcome the authors recommend intravenous immunoglobulin in cases of severe bleeding or when the platelet level is under 10 x 10(9) l.
Alliot
Carol
C
Haematology-Oncology Division, General Hospital of Annemasse, BP 525, 8 rue du Chablais, 74107 Annemasse Cedex, France. alliotcfr@yahoo.fr
Barrios
Marta
M
D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D003092:Colitis / Q000150:complications / Q000821:virology; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology; D015774:Ganciclovir / Q000009:adverse effects / Q000627:therapeutic use; D005938:Glucocorticoids / Q000008:administration & dosage; D006470:Hemorrhage / Q000188:drug therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage*; D008297:Male; D010976:Platelet Count / Q000379:methods; D011241:Prednisone / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000150:complications / Q000821:virology
D000998:Antiviral Agents; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D015774:Ganciclovir; D011241:Prednisone