title: Severe immune thrombocytopenia possibly elicited by the anti-influenza viral agent peramivir.
abstract: A 44-year-old man whose platelet count had been at the lower limit of the normal range for years visited the urgent care department of our hospital for treatment of a high fever and severe fatigue. The influenza A virus was detected, and the patient therefore received the intravenous antiviral agent, peramivir. One week later, he developed systemic petechial rashes. A peripheral blood examination showed a markedly decreased platelet count (3.0×10(9) cells/L), and the bone marrow findings were compatible with a diagnosis of immune thrombocytopenia (ITP). Furthermore, a drug-induced lymphocyte-stimulating test was positive for peramivir. The thrombocytopenia slowly responded to treatment with oral prednisolone. This case suggests that neuraminidase inhibitors, including peramivir, can elicit or worsen ITP.
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Harada-Shirado
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ikeda
authors.forename: Miki
authors.initials: M
authors.lastname: Furukawa
authors.forename: Masumi
authors.initials: M
authors.lastname: Sukegawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Akiko
authors.initials: A
authors.lastname: Shichishima-Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohkawara
authors.forename: Hideyoshi
authors.initials: H
authors.lastname: Noji
authors.forename: Kinuyo
authors.initials: K
authors.lastname: Kawabata
authors.forename: Shun-ichi
authors.initials: S
authors.lastname: Saito
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ohto
authors.forename: Kazuei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D000146:Acids, Carbocyclic; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003517:Cyclopentanes / Q000009:adverse effects* / Q000627:therapeutic use; D006146:Guanidines / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D009980:Influenza A virus; D007251:Influenza, Human / Q000188:drug therapy; D008297:Male; D010976:Platelet Count; D011239:Prednisolone / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000276:immunology
chemical_list: D000146:Acids, Carbocyclic; D000998:Antiviral Agents; D003517:Cyclopentanes; D006146:Guanidines; D011239:Prednisolone; C414210:peramivir