title: [Plasmodium vivax malaria with clinical presentation mimicking acute type idiopathic thrombocytopenic purpura].
abstract: Causes of thrombocytopenia are diverse, and infection with plasmodia often brings about thrombocytopenia. Japan is not an endemic area of malaria infection at present and most cases are travelers to endemic areas. In some cases, initial clinical diagnoses may not be correct because of a variety of symptoms, physical findings and laboratory abnormalities. A 67-year-old female, who had traveled to South American countries 2 months before the onset of the disease, presented with a case of vivax malaria. Because of the patient's high fever, profound thrombocytopenia (1.5 x 10(4)/microl), and elevated platelet-associated IgG on admission, our initial diagnosis was acute type idiopathic thrombocytopenic purpura (ITP). However, we recognized her tertian fever and plasmodial vivax in erythrocytes 4 days later. She responded promptly to anti-parasitic therapy after diagnosis of malaria and her laboratory data also improved. Travel history is indicative of malaria infection in some cases with thrombocytopenia mimicking acute ITP.
authors.affiliation: Molecular Medicine Unit Atomic Bomb Disease Institute, Nagasaki University, Graduate School of Biomedical Sciences.
authors.forename: Minori
authors.initials: M
authors.lastname: Komoda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujimoto
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Tsushima
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukushima
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsukasaki
authors.forename: Masao
authors.initials: M
authors.lastname: Tomonaga
mesh_terms: D000208:Acute Disease; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016780:Malaria, Vivax / Q000175:diagnosis*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis*; D013020:South America; D014195:Travel