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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 110 - 116 (7page)
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Background Cytomegalovirus (CMV) causes severe diseases in premature infants and immunocompromised hosts, and antiviral therapy is often required for disease control. However, the clinical manifestations and treatment courses for CMV-associated thrombocytopenia in immunocompetent children are unclear. Methods Medical records of the children who suffered from thrombocytopenia, and showed pos-itive CMV polymerase chain reaction and CMV-like symptoms were retrospectively analyzed at three university hospitals in Daegu from January 2000 to March 2017. Patients suffering from leukemia, immunodeficiency, and other infections were excluded. Results Among 1,065 children with thrombocytopenia, 29 (2.7%) displayed CMV-associated thrombocytopenia. The median age at diagnosis was 15 months and the median platelet count was 26,000/L. They were classified into the CMV-induced thrombocytopenia (23/29) and CMV-related secondary immune thrombocytopenia (ITP, 6/29) groups. Fourteen subjects had hepatic dysfunction, four had Evans syndrome, two had pneumonitis, and one had gastritis. IVIG was used for 21 patients, and six patients among them showed recurrence, for whom IVIG or antiviral therapy was used. All, except one, re-current or chronic cases belonged to the CMV-induced thrombocytopenia group. Antiviral therapy was used more frequently for the CMV-induced thrombocytopenia group (8/23, 34.8%) than for the CMV-related secondary ITP group (0/6); however, the results were not statistically significant (P=0.148). Conclusion CMV is a rare but unique etiology of thrombocytopenia, and observed even in healthy children after the neonatal period. About one-third patients need antiviral therapy for dis-ease control. Further, CMV-induced thrombocytopenia is more complex than CMV-related secondary ITP.
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참고문헌 (30)
참고문헌 신청
Arruda VR / 1997 / Cytomegalovirus infection as cause of severe thrombocytopenia in a nonimmunosuppressed patient / Acta Haematol 98:228~230
Boppana SB / 1992 / Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality / Pediatr Infect Dis J 11:93~99
Mutter W / 1988 / Failure in generating hemopoietic stem cells is the primary cause of death from cytomegalovirus disease in the immunocompromised host / J Exp Med 167:1645~1658
Shrestha R / 2014 / Cytomegalovirus: a possible cause of persistent refractory immune thrombocytopenic purpura / JAIM 3:42~45
Shimanovsky A / 2016 / Refractory immune thrombocytopenic purpura and cytomegalovirus infection: a call for a change in the current guidelines / Mediterr J Hematol Infect Dis 8:e2016010
Boppana SB / 1992 / Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality / Pediatr Infect Dis J 11:93~99
Mutter W / 1988 / Failure in generating hemopoietic stem cells is the primary cause of death from cytomegalovirus disease in the immunocompromised host / J Exp Med 167:1645~1658
Shrestha R / 2014 / Cytomegalovirus: a possible cause of persistent refractory immune thrombocytopenic purpura / JAIM 3:42~45
Shimanovsky A / 2016 / Refractory immune thrombocytopenic purpura and cytomegalovirus infection: a call for a change in the current guidelines / Mediterr J Hematol Infect Dis 8:e2016010
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