Cytomegalovirus-associated idiopathic thrombocytopenic purpura in Chinese children.
The objective was to investigate the clinical features, glycoprotein B (gB) genotype and therapy of the human cytomegalovirus (CMV)-associated idiopathic thrombocytopenic purpura (ITP) in Chinese children. Clinical features and laboratory data of 25 CMV-associated ITP, including 18 males and 7 females with a median age of 0.3 y, were analysed and compared with 116 CMV-negative ITP. The CMV gB of 17 cases was genotyped. Apart from dermatorrhagia, jaundice was noted in 6 cases. Cough, diarrhoea, fever, splenohepatomegaly, alimentary tract haemorrhage and raised ALT were also found. Compared with CMV-negative ITP, CMV-associated ITP has a younger median age, raised ALT and AST, and longer hospitalization (p<0.05, respectively). The most prevalent genotype was gB1 (15/17), followed by coinfection and gB3. Compared with congenitally CMV-infected children in our previous study, more prevalence of gB1 was noted (40/79 vs 15/17, p=0.004). Most of these cases were receiving the therapy of immunoglobulin, corticoid and/or gancyclovir with good therapeutic effect except for 2 cases. In conclusion, CMV infection, especially gB1 genotype, is an important cause of ITP and careful examination of markers of CMV in all cases of apparent 'idiopathic' ITP is required. Combination therapy of immunoglobulin, corticoid and gancyclovir is effective.
Sheng Yu
Zhong
Z
Department of Medicine, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Tang
Lan Fang
LF
Zou
Chao Chun
CC
Yan Zheng
Ji
J
Zhao
Zheng Yan
ZY
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007223:Infant; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D004279:DNA, Viral; D007136:Immunoglobulins; D015774:Ganciclovir