Abstract
EBV infection can occur worldwide. We managed a 17 year old male who developed transient pancytopenia followed by thrombocytosis concurrent with EBV infection. To the best of our knowledge we have not encountered any cases of thrombocytosis concurrent with EBV infection before. Our case was diagnosed as a case of EBV infection with the help of serology and managed conservatively. In our case, though it is uncommon to find thrombocytosis due to EBV infection, it is possible that following pancytopenia concurrent with the EBV infection, the patient might have developed secondary or reactive thrombocytosis due to elevated endogenous levels of thrombopoietin, interleukin-6, catecholamines.
Highlights
EBV infection can occur in any part of the world and infection is common in early childhood and the second peak can occur during late adolescence, most of the EBV infections in infants and young children are asymptomatic
The patient was given blood transfusion for anemia following supportive treatment,after about 7 days of admission he developed thrombocytosis,with maximum platelates count reaching upto 10,5900/mm[3] which fell on its own to normal range within a period of 1 week,during which he was carefully observed for possible complications.He didn’t develop any complications of thrombocytosis.After 2 weeks of in-hospital medical management his Hb-13.8 g/dl,total count-7700/mm[3] with neutrophils-67%lymphocytes- 31% and eosinophils2%,platelets-527,000/mm[3].He was discharged and asked for follow up in 2 weeks. our patient was diagnosed with the help of EBV viral capsid antigen (VCA) and managed with supportive treatment and he recovered
Reactive thrombocytosis can be caused by increased endogenous levels of thrombopoietin,IL-6 and catecholamines.These mediators are produced because of inflammation,infection,and neoplastic conditions or situations causing stress.The levels of thrombopoietin are high in reactive thrombocytosis.[8,9]
Summary
EBV infection can occur in any part of the world and infection is common in early childhood and the second peak can occur during late adolescence, most of the EBV infections in infants and young children are asymptomatic. Case Report: A seventeen year-old male presented with complaints of easy fatigability of 4 months duration,abdominal pain of 1 months duration and fever for 5 days. He had decreased energy associated with fatigue, decreased appetite. The fever was intermittent not associated with chills and sweating,with maximum documented temperature being 102 degree F.He presented to our centre with those complaints He had no significant past medical history. The patient was given blood transfusion for anemia following supportive treatment,after about 7 days of admission he developed thrombocytosis,with maximum platelates count reaching upto 10,5900/mm[3] which fell on its own to normal range within a period of 1 week,during which he was carefully observed for possible complications.He didn’t develop any complications of thrombocytosis.After 2 weeks of in-hospital medical management his Hb-13.8 g/dl,total count-7700/mm[3] with neutrophils-67%lymphocytes- 31% and eosinophils2%,platelets-527,000/mm[3].He was discharged and asked for follow up in 2 weeks. our patient was diagnosed with the help of EBV VCA and managed with supportive treatment and he recovered
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