title: Immune Thrombocytopenic Purpura Secondary to Cytomegalovirus Infection: A Case Report.
abstract: Immune thrombocytopenic purpura (ITP) is defined as an acquired thrombocytopenia with antibodies detected against platelet surface antigens, and it is the most common form of thrombocytopenia in otherwise asymptomatic adults. ITP secondary to an underlying condition is a diagnosis of exclusion that is essential to establish for treatment efficacy. Secondary thrombocytopenia caused by cytomegalovirus (CMV) is common; however, case reports associated with diagnosis in immunocompetent adults are rare, and to the best of our knowledge only 20 publications have been associated with this diagnosis. Our report is based on a clinical presentation of a 37-year-old female complaining of petechiae, heavy menses, shortness of breath, and a platelet count of 1 × 10(9)/L. Treatment with IVIG and steroids failed to improve platelet count. Subsequently, an infectious laboratory workup was performed, detecting CMV infection, and treatment with antiviral agents was initiated, causing platelet count to increase as viral load decreased.
authors.affiliation: Department of Internal Medicine, St. Barnabas Hospital Bronx , Bronx, NY , USA.
authors.forename: Bessy S
authors.initials: BS
authors.lastname: Flores-Chang
authors.affiliation: Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Arias-Morales
authors.affiliation: Department of Internal Medicine, St. Barnabas Hospital Bronx , Bronx, NY , USA.
authors.forename: Francis G
authors.initials: FG
authors.lastname: Wadskier
authors.affiliation: Department of Internal Medicine, St. Barnabas Hospital Bronx , Bronx, NY , USA.
authors.forename: Sorab
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA.
authors.forename: Nicoleta
authors.initials: N
authors.lastname: Stoicea
keywords: bleeding; cytomegalovirus; immune thrombocytopenic purpura; steroids; valgancyclovir