Severe thrombocytopenia rare but potentially fatal in patients with Zika
Severe thrombocytopenia is a rare but potentially fatal outcome in patients with Zika virus infection, and treating such cases for idiopathic thrombocytopenic purpura may be more effective than platelet transfusion, a study found.
Researchers from the CDC and Puerto Rico Department of Health reviewed the medical records of patients diagnosed with Zika virus infection in 2016 in Puerto Rico, which was hit hard during the Zika epidemic.
According to Tyler M. Sharp, PhD, a U.S. Public Health Service commander and epidemiologist for the CDCs Dengue Branch, and colleagues, among 37,878 patients identified with Zika, 0.1% (n = 47) had thrombocytopenia, including 12 with severe thrombocytopenia. Most — 77% — were adults and 53% were male, findings showed.
The platelet nadir, or low point, occurred a median of 6 days after symptom onset for patients with severe thrombocytopenia and a median of 5 days after symptom onset for those with nonsevere thrombocytopenia, Sharp and colleagues reported. Bleeding was experienced by all patients with severe thrombocytopenia, 33% were admitted to the ICU and 8% died, they said. Half were treated for ITP.
According to the study, five patients with severe thrombocytopenia were treated with IVIg and four patients received platelet transfusion. Sharp and colleagues reported a median platelet count increase of 112 X 109 cells/L among patients treated with IVIg, compared with a median increase of 8.5 X 109 cells/L among patients who had a platelet transfusion.
“Patients with severe thrombocytopenia associated with Zika virus infection should be managed for ITP, including administration of IVIg or corticosteroids, but not platelet transfusion,” Sharp told Infectious Disease News. – by Marley Ghizzone
Disclosures: The authors report no relevant financial disclosures.