Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Acute Idiopathic Thrombocytopenic Purpura Following Influenza B Virus Infection

B형 인플루엔자 감염에서 나타난 특발성 혈소판 감소성 자색반증

  • Jung, Seungwon (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Kang, Sunghee (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Kang, Jin Han (Department of Pediatrics, The Catholic University of Korea College of Medicine) ;
  • Ma, Sang Hyuk (Department of Pediatrics, Fatima Hospital)
  • 정승원 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강성희 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실) ;
  • 마상혁 (창원 파티마병원 소아청소년과)
  • Received : 2015.02.07
  • Accepted : 2015.07.13
  • Published : 2015.08.25
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Abstract

Virus-associated immune thrombocytopenic purpura (ITP) can occur following common viruses, but cases of ITP associated with influenza infection has seldom been reported. In this report we describe a previously healthy 5-year-old boy who admitted with fever, flu-like symptoms and a few bruises on both legs. Severe thrombocytopenia were found. Bone marrow aspirates and biopsy showed no abnormalities and results of coagulation tests were all in normal limit. Real-time polymerase chain reaction was positive for influenza B infection. The patient fully recovered with intravenous immunoglobulins and steroid therapy.

인플루엔자 백신 접종에 의한 특발성 혈소판 감소증은 드물게 나타나지만, 인플루엔자 감염환자에서 병발한 혈소판 감소성 자색반증은 거의 보고된 바가 없다. 특이 병력 없던 건강한 5세 남자 환자가 고열과 독감 증상으로 내원하였으며, 혈액검사에서 심한 혈소판 감소증을 보였다. 환아는 신속항원검사, 실시간 중합효소연쇄반응을 통해 B형 인플루엔자 감염을 확진받았으며, 골수 천자 및 생검을 포함한 다른 검사실 검사상 혈소판 감소를 유발할만한 다른 원인은 보이지 않았다. 환아는 정맥 면역글로불린과 프레드니솔론 투여로 정상 혈소판 수치를 회복하였다. 본 증례는 B형 인플루엔자로 인한 혈소판 감소성 자색반증의 첫번째 증례이다. 드물지만 인플루엔자 감염에서도 이처럼 심한 혈소판 감소가 동반될 수 있으므로 외래에서 독감 의증 환자를 진찰할 때에는 멍이나 출혈 흔적 등을 놓치지 않도록 세밀하게 진찰해야 하고 의심이 될 때에는 혈액 검사가 필요할 것으로 생각된다.

Keywords

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  1. Epidemiology and Viral Etiology of Pediatric Immune Thrombocytopenia through Korean Public Health Data Analysis vol.10, pp.7, 2015, https://doi.org/10.3390/jcm10071356