PEDIATRICS Vol. 82 No. 6 December 1988, pp. 905-908
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Thrombocytopenia and Human Immunodeficiency Virus in Children

Maadhava Ellaurie MD1, Edward R. Burns MD1, Larry J. Bernstein MD1, Kiran Shah MD1, and Arye Rubinstein MD1

1 From the Division of Allergy Immunology, Department of Pediatrics and the Department of Laboratory Medicine, Albert Einstein College of Medicine, Bronx, New York

Thrombocytopenia occurs in 13% of children with symptomatic human immunodeficiency virus (HIV) infection. The clinical and laboratory course of 19 children infected with HIV with thrombocytopenia is described. Bone marrow aspirates showed normal to increased numbers of megakaryocytes. Levels of antiplatelet antibodies were increased in 80% of the children and circulating immune complexes were found in 74%. Clinically significant hemorrhage leading to anemia occurred in five patients, and CNS bleeding led to a fatal outcome in an additional three children. Spontaneous remission of thrombocytopenia occurred in three of the 19 subjects. High-dose IV ggr globulin was effective in increasing the platelet counts of six of 15 patients (40%) but resulted in a sustained remission in only one subject. Oral prednisone was effective in increasing the platelet count of two thirds of those whose platelet counts could not be controlled by IV ggr-globulin. Bleeding manifestations were eliminated in all patients whose platelet counts increased significantly. Of the 11 children whose counts increased either spontaneously or as a result of therapy, eight remain alive (72%). In contrast, all of the eight patients whose platelet counts did not improve have died. Thrombocytopenia in children with HIV disease is engendered by immune mechanisms and is a major cause of morbidity and mortality. High-dose IV ggr-globulin and/or corticosteroids are temporarily effective in increasing the platelet count and reducing bleeding in about half of thrombocytopenic patients and are recommended for use. The ability to respond to therapy correlates with improved survival.

Key Words: thrombocytopenia • human immunodeficiency virus • acquired immunodeficiency syndrome • opportunistic infection • acquired immunodeficiency syndrome-related complex

Submitted on July 24, 1987
Accepted on February 17, 1988




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M. Ellaurie
Thrombocytosis in Pediatric HIV Infection
Clinical Pediatrics, September 1, 2004; 43(7): 627 - 629.
[Abstract] [PDF]