Incidence and Outcome of Severe and Nonsevere Thrombocytopenia Associated With Zika Virus Infection—Puerto Rico, 2016
| Autor: | Tyler M. Sharp, Melissa Bello-Pagan, Stephen H. Waterman, Paige Neaterour, Brenda Rivera-Garcia, Aidsa Rivera, Laura Adams, Priscilla Baez, Jorge L. Muñoz-Jordán, Myriam Garcia, Nimia Reyes, Elizabeth A. Van Dyne, Lisa C. Richardson |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 030106 microbiology Population thrombocytopenia Gastroenterology Major Articles Zika virus law.invention 03 medical and health sciences Zika 0302 clinical medicine law hemic and lymphatic diseases Internal medicine medicine Platelet 030212 general & internal medicine education education.field_of_study biology business.industry Medical record Incidence (epidemiology) biology.organism_classification Intensive care unit Infectious Diseases Platelet transfusion immune thrombocytopenia Oncology platelets Etiology ITP business |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| Popis: | Background Zika virus (ZIKV) infection has been associated with severe thrombocytopenia. We describe the incidence, clinical manifestations, and outcomes of patients with ZIKV infection and thrombocytopenia. Methods We reviewed medical records of patients with ZIKV infection and thrombocytopenia (platelet count Results Of 37 878 patients with ZIKV infection, 47 (0.1%) had thrombocytopenia in the absence of an alternative etiology (1.4 cases/100 000 population), including 12 with severe thrombocytopenia. Most patients with thrombocytopenia were adult (77%) and male (53%). Platelet nadir occurred a median (range) of 6 (1–16) and 5 (0–34) days after symptom onset for patients with severe and nonsevere thrombocytopenia, respectively. Among patients with severe thrombocytopenia, all had bleeding, 33% were admitted to the intensive care unit, and 8% died; 50% were treated for ITP. Among 5 patients with severe thrombocytopenia who received intravenous immunoglobulin, the median platelet count increase (range) was 112 (65–202) ×109/L. In contrast, among 4 patients who received platelet transfusion, the median increase in platelet count (range) was 8.5 (–6 to 52) ×109/L. Conclusions Patients with severe thrombocytopenia and ZIKV infection experienced prominent acute morbidity. Consistent with recommended management, administration of ITP treatments to such patients may be more efficacious than platelet transfusion in resolving thrombocytopenia. Severe thrombocytopenia should be considered a rare outcome of ZIKV infection. |
| Databáze: | OpenAIRE |
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