title: Relapse of immune thrombocytopenia associated with varicella 20 years after splenectomy.
abstract: A 45-year-old man who had undergone splenectomy 20 years earlier for immune thrombocytopenia (ITP) presented with a fever, arthralgia and vesicular skin rash. The skin rash was typical for varicella, as confirmed on serological studies. He exhibited isolated thrombocytopenia and was diagnosed with ITP. In addition, an accessory spleen was detected. The platelet count responded to treatment with prednisolone (PSL), and the varicella subsided uneventfully following therapy with acyclovir. Furthermore, the platelet count was maintained after PSL was discontinued. This case suggests an etiological link between varicella and very late relapse of ITP after initial splenectomy.
authors.affiliation: Internal Medicine, St. Luke's International Hospital, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Yoshida
authors.forename: Takakazu
authors.initials: T
authors.lastname: Higuchi
authors.forename: Luka
authors.initials: L
authors.lastname: Suzuki
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Koyamada
authors.forename: Sadamu
authors.initials: S
authors.lastname: Okada
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D018771:Arthralgia / Q000209:etiology; D002644:Chickenpox / Q000150:complications*; D002908:Chronic Disease; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011239:Prednisolone / Q000627:therapeutic use*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000821:virology*; D012008:Recurrence; D013156:Splenectomy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D011239:Prednisolone; D000212:Acyclovir