TY - JOUR
T1 - A review of severe thrombocytopenia in Zika patients – Pathophysiology, treatment and outcome
AU - de Pijper, Cornelis Adrianus
AU - Schnyder, Jenny Lea
AU - Stijnis, Cornelis
AU - Goorhuis, Abraham
AU - Grobusch, Martin Peter
N1 - Publisher Copyright: © 2021
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Background: During the 2015 Zika virus infection (ZVI) epidemic swiping through the Americas, few cases of ZVI with severe, potentially life-threatening thrombocytopenia were reported. Platelet transfusion, corticosteroids and intravenous immunoglobulins (IVIG) were in most cases applied as therapeutic options, predominantly with success. We present a comprehensive overview concerning the pathophysiology, treatment strategies and outcomes of patients with ZVI and severe thrombocytopenia (platelet count <50 × 109/L). Method: A literature search was performed. Results: Eleven case reports and case series with a total of 28 patients met the inclusion criteria; including five cases with lethal outcome. Therapeutic strategies, including platelet transfusion, administration of steroids and/or IVIG were described in 24 cases. Conclusions: Severe thrombocytopenia is a rare, but potentially life-threatening complication of ZVI. The principal pathophysiological mechanism appears to immune-induced thrombocytopenia. Due to a paucity of cases, the optimal treatment strategy remains to be elucidated.
AB - Background: During the 2015 Zika virus infection (ZVI) epidemic swiping through the Americas, few cases of ZVI with severe, potentially life-threatening thrombocytopenia were reported. Platelet transfusion, corticosteroids and intravenous immunoglobulins (IVIG) were in most cases applied as therapeutic options, predominantly with success. We present a comprehensive overview concerning the pathophysiology, treatment strategies and outcomes of patients with ZVI and severe thrombocytopenia (platelet count <50 × 109/L). Method: A literature search was performed. Results: Eleven case reports and case series with a total of 28 patients met the inclusion criteria; including five cases with lethal outcome. Therapeutic strategies, including platelet transfusion, administration of steroids and/or IVIG were described in 24 cases. Conclusions: Severe thrombocytopenia is a rare, but potentially life-threatening complication of ZVI. The principal pathophysiological mechanism appears to immune-induced thrombocytopenia. Due to a paucity of cases, the optimal treatment strategy remains to be elucidated.
KW - Immune-mediated thrombocytopenia (ITP)
KW - Intravenous immunoglobulins (IVIG)
KW - Review
KW - Steroid application
KW - Zika virus infection
UR - http://www.scopus.com/inward/record.url?scp=85120724214&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.tmaid.2021.102231
DO - https://doi.org/10.1016/j.tmaid.2021.102231
M3 - Review article
C2 - 34896327
SN - 1477-8939
VL - 45
JO - Travel medicine and infectious disease
JF - Travel medicine and infectious disease
M1 - 102231
ER -