A review of severe thrombocytopenia in Zika patients – Pathophysiology, treatment and outcome. Issue 45 (January 2022)

• Record Type: Journal Article
• Authors: De Pijper, Cornelis Adrianus; Schnyder, Jenny Lea; Stijnis, Cornelis; Goorhuis, Abraham; Grobusch, Martin Peter
• Is Part Of: Travel medicine and infectious disease. Issue 45(2022)
• Publication Date: 2022-01
• Subjects: Zika virus infection -- Immune-mediated thrombocytopenia (ITP) -- Intravenous immunoglobulins (IVIG) -- Steroid application -- Review; Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2021.102231
• Languages: English
• ISSNs: 1477-8939

Abstract

Abstract: 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 × 10 9 /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.