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.