title: Cytomegalovirus-associated idiopathic thrombocytopenic purpura in Chinese children.
abstract: 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.
authors.affiliation: Department of Medicine, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Sheng Yu
authors.forename: Lan Fang
authors.initials: LF
authors.lastname: Tang
authors.forename: Chao Chun
authors.initials: CC
authors.lastname: Zou
authors.forename: Ji
authors.initials: J
authors.lastname: Yan Zheng
authors.forename: Zheng Yan
authors.initials: ZY
authors.lastname: Zhao
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D004279:DNA, Viral; D007136:Immunoglobulins; D015774:Ganciclovir