HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Acute renal failure in a child with thrombocytopenic purpura caused by acute Epstein-Barr virus infection after treatment with anti-D immunoglobulin.

Abstract
Immune thrombocytopenia (ITP) in children is usually a benign, self-limiting disorder. An acute Epstein-Barr virus (EBV) infection usually causes atypical lymphocytosis and mild decrease in platelets. Severe thrombocytopenia is an extremely rare complication. Anti-D immunoglobulin has been used for treatment of ITP in Rh(D)-positive nonsplenectomized patients. Severe hemolysis and acute renal failure are extremely rare complications that may be aggravated by the presence of an acute EBV infection. It is believed that anti-D immunoglobulin triggers an unusual virus-induced immune response causing hemolysis. We present a 4-year-old girl with ITP caused by an acute EBV infection that developed acute kidney injury following treatment with anti-D immunoglobulin. The patient recovered completely from thrombocytopenia and renal dysfunction. Intravascular hemolysis and acute kidney injury are consistent with anti-D immunoglobulin mechanism of action. Pediatric patients treated with anti-D immunoglobulin for ITP should be closely monitored for signs and symptoms of hemolysis that may be aggravated by the presence of EBV infection leading to impaired renal function.
AuthorsLydia Kossiva, Dimitrios Kyriakou, Andromachi Mitsioni, Anastasia Garoufi
JournalPediatric emergency care (Pediatr Emerg Care) Vol. 29 Issue 6 Pg. 748-50 (Jun 2013) ISSN: 1535-1815 [Electronic] United States
PMID23736070 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Viral
  • Immunoglobulin M
  • Isoantibodies
  • RHO(D) antibody
  • Rho(D) Immune Globulin
  • Furosemide
Topics
  • Acute Kidney Injury (drug therapy, etiology)
  • Antibodies, Viral (blood)
  • Child, Preschool
  • Diagnosis, Differential
  • Epstein-Barr Virus Infections (blood, complications)
  • Female
  • Fluid Therapy
  • Furosemide (therapeutic use)
  • Hemolysis (immunology)
  • Hemolytic-Uremic Syndrome (diagnosis)
  • Herpesvirus 4, Human (immunology)
  • Humans
  • Immunoglobulin M (blood)
  • Immunotherapy
  • Infusions, Intravenous
  • Isoantibodies (adverse effects)
  • Purpura, Thrombocytopenic, Idiopathic (etiology, therapy)
  • Rho(D) Immune Globulin

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: