الفهرس 
Immune Thrombocytopenic Purpura
Prevelance of CMV in ITP patientsOnly 14 pages are availabe for public view
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Abstract
Background: Immune thrombocytopenia (ITP) in children is usually a short self-limiting disease with favorable prognosis characterized by increased platelet destruction and decreased platelet number. However, the condition can become chronic in 5% to 30% of affected children. It may be triggered by viral infection as many reports documenting the relationship of viral infections with ITP. CMV infection may result in severe, refractory ITP. Treatment with steroids was shown to worsen the course of HCMV-associated ITP. Aim: To assess the effect of CMV infection on the course of ITP and to evaluate the effect of CMV positivity on the INF gamma and its input on bleeding manifestations and outcome in patients with ITP. Methods: A cross sectional prospective study; in patients aged 2-12 years with acute and persistent ITP. Thirty-one acute and persistent ITP patients were enrolled in the study. CMV serology was done for each patient. CMV IgG avidity was assessed in CMV IgM positive patients and IFN gamma was measured by flow cytometry for each acute and persistent ITP patients. Then the differences between positive and negative cases was evaluated according to blood picture, ITP (SMOG score), treatment and response of treatment. Results: The incidence rate of CMV IgM positive in acute and persistent ITP patients was 22. %. In addition, all the studied chronic ITP patients showed CMV IgG positivity and all CMV IgM positive cases showed high CMV IgG avidity which indicate long standing infection. High IFN gamma levels were observed in all the studied acute and persistent ITP cases. CMV IgM positive cases did not differ from CMV IgM negative cases in terms of age, gender, history of viral illness, clinical presentation, SMOG score, blood picture, platelet count at the time of diagnosis. Response to initial treatment was similar in both. Conclusion: active CMV infection is common in children with ITP. However, CMV infections didn’t seem to have an appreciable impact on the clinical course and the response to treatment on children with ITP. In addition, High level of IFN gamma may play role in its pathophysiology.