Chronic autoimmune thrombopenia/neutropenia in a boy with persistent parvovirus B19 infection

Objective: We report an Ii-year-old boy presenting with splenomegaly, chron ic thrombocytopenia and concordant neutropenia. Results: In contrast to aut oantibodies against platelets, there were no detectable neutrophil-specific autoantibodies present in this patient. Extensive serologic investigations revealed increased IgM- and IgG-antibody titers against parvovirus B19. A nested polymerase chain reaction (PCR) showed parvovirus B19-specific seque nces in the patient's bone-marrow cells but not in the serum. Specific anti bodies against the structural proteins VP1 and VP2 in addition to those aga inst non-structural protein NS1 of parvovirus B19 were detected by Western blot analysis. Thrombocytopenia and neutropenia responded to immunosuppress ive therapy and subsequent splenectomy, the latter being necessary due to s evere side-effects of steroid medication. Conclusion: Autoimmune thrombocyt openia/neutropenia may have been triggered and/or sustained by a chronic pa rvovirus B19 infection. Patients with this very rare disorder should be scr eened for this virus. (C) 2001 Elsevier Science B.V. All rights reserved.