Primary Active Epstein-Barr Virus Infection Coexisting with Immune Thrombocytopenia in Children-A Rare Trigger Factor of Immun Thrombocytopenia: Two Case Reports

Abstract

Immune thrombocytopenia (ITP) is a reason of thrombocytopenia that is characterized by isolated thrombocytopenia in childhood. Epstein barr virus infection (EBV) is a mildly and uncomplicated ailment that might be a trigger factor for ITP. Here, we discuss two cases with ITP secondary Epstein barr virus infection.

Keywords

• Immun thrombocytopenia
• Epstein-Barr virus
• children

Çocuklarda İmmün Trombositopeni ile Birlikte Görülen Primer Aktif Epstein-Barr Virüs Enfeksiyonu - İmmün Trombositopeninin Nadir Bir Tetikleyici Faktörü: İki Olgu Sunumu

Abstract

İmmün trombositopeni (ITP), çocukluk çağında izole trombositopeni ile karakterize bir trombositopeni nedenidir. Epstein barr virüs enfeksiyonu (EBV) ITP için tetikleyici bir faktör olabilecek hafif ve komplikasyonsuz bir hastalıktır. Burada, Epstein barr virüs enfeksiyonuna ikincil ITP gelişen iki olgu tartışılmıştır.

Keywords

• immün trombositopeni
• Ebstein-Barr virüs
• çocuk

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical Statement

Informed Consent: Informed consent was taken prior to writing this case report from the patient’s parents.

References

1. 1. Rodeghiero F, Stasi R, Gernsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 2009; 113:2386–2393.
2. 2. Correia S, Bridges R, Wegner F, et al. Sequence Variation of Epstein-Barr Virus: Viral Types, Geography, Codon Usage, and Diseases. J Virol 2018; 92: e01132-18.
3. 3. Pipp ML, Means ND, Sixbey JW, Morris KL, Gue CL, Baddour LM. Acute Epstein- Barr virus infection complicated by severe thrombocytopenia. Clin Infect Dis 1997; 25:1237–9.
4. 4. Zeller B, Rajantie J, Hedlund-Treutiger I, et al. Childhood idiopathic thrombocytopenic purpura in the Nordic countries: epidemiology and predictors of chronic disease. Acta Paediatr 2005; 94:178-84.
5. 5. Chiang MR, Wei CC, Muo CS, Fu LS, Li TC, Kao CH. Association of primary immune thrombocytopenia and common allergic diseases among children. Pediatr Res 2015; 77:597-601.
6. 6. Ebell MH. Epstein-Barr virus infectious mononucleosis. Am Fam Physician 2004; 70:1279-87.
7. 7. Elalfy MS, Nugent D. Viruses, anti-viral therapy, and viral vaccines in children with immune thrombocytopenia. Semin Hematol 2016; 53:70-72.
8. 8. Nielsen TR, Rostgaard K, Nielsen NM, et al. Multiple sclerosis after infectious mononucleosis. Arch Neurol 2007; 64:72-75.

9. 9. Norris PAA, Kaur G, Lazarus AH. New insights into IVIg mechanisms and alternatives in autoimmune and inflammatory diseases. Curr Opin Hematol 2020; 27:392-398