acyclovir and Purpura--Thrombocytopenic--Idiopathic

Acyclovir has been widely used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus (VZV). The common adverse effects of this drug include nausea, diarrhea, headache, dizziness and mental changes. The immune thrombocytopenia induced by acyclovir is rare.. A 67-year-old Chinese male who was given acyclovir 5 mg kg. There have been few reports of acyclovir-induced immune thrombocytopenia. This is the first case report and literature review of acyclovir-induced immune thrombocytopenia, with tongue hematoma as the first sign. Dentists should never overlook this rare adverse effect of acyclovir, as a rapid and appropriate treatment may prevent further severe life-threatening complications.

Topics: Acyclovir; Aged; Antiviral Agents; Hematoma; Humans; Infusions, Intravenous; Male; Platelet Count; Purpura, Thrombocytopenic, Idiopathic; Tongue

A 45-year-old man who had undergone splenectomy 20 years earlier for immune thrombocytopenia (ITP) presented with a fever, arthralgia and vesicular skin rash. The skin rash was typical for varicella, as confirmed on serological studies. He exhibited isolated thrombocytopenia and was diagnosed with ITP. In addition, an accessory spleen was detected. The platelet count responded to treatment with prednisolone (PSL), and the varicella subsided uneventfully following therapy with acyclovir. Furthermore, the platelet count was maintained after PSL was discontinued. This case suggests an etiological link between varicella and very late relapse of ITP after initial splenectomy.

Topics: Acyclovir; Antiviral Agents; Arthralgia; Chickenpox; Chronic Disease; Fever; Humans; Male; Middle Aged; Platelet Count; Prednisolone; Purpura, Thrombocytopenic, Idiopathic; Recurrence; Splenectomy; Time Factors; Treatment Outcome

Topics: Acyclovir; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived; Antiviral Agents; Blister; Hemorrhage; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunologic Factors; Male; Opportunistic Infections; Purpura, Thrombocytopenic, Idiopathic; Rituximab; Valacyclovir; Valine

Topics: Acyclovir; Antiviral Agents; Glucocorticoids; Hemorrhage; Herpes Zoster; Humans; Immunoglobulins, Intravenous; Male; Middle Aged; Prednisone; Purpura, Thrombocytopenic, Idiopathic; Skin Diseases, Vesiculobullous; Splenectomy; Valacyclovir; Valine

Topics: Acyclovir; Antibodies, Viral; CD4 Lymphocyte Count; Disease Progression; Eye Infections, Viral; Female; Fluorescein Angiography; Fundus Oculi; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; HIV Antibodies; HIV Seronegativity; Humans; Immunocompromised Host; Middle Aged; Prednisolone; Purpura, Thrombocytopenic, Idiopathic; Retinal Necrosis Syndrome, Acute

Idiopathic (autoimmune) thrombocytopenic purpura has been previously reported as a rare complication in children and in a few adults following chickenpox. We report a case of varicella zoster virus-associated idiopathic thrombocytopenic purpura in an adult liver transplant recipient following dermatomal zoster. Idiopathic thrombocytopenic purpura developed 3 days after the onset of herpes zoster in our patient, with a nadir platelet count of 3000/mm3. The patient was treated with intravenous gamma globulin with recovery of thrombocytopenia after 3 weeks. Transplant clinicians need to be aware that this serious and potentially life-threatening complication may occur with herpes zoster in transplant recipients.

Topics: Acyclovir; Herpes Zoster; Humans; Immunoglobulins, Intravenous; Immunosuppressive Agents; Liver Transplantation; Male; Middle Aged; Platelet Count; Purpura, Thrombocytopenic, Idiopathic