A clinical case of thrombocytopenic purpura in a 13-year-old child

Background. Immune thrombocytopenic purpura is an immune-mediated disease that develops as a result of impaired immune tolerance to platelet antigens and the formation of antibodies to them, followed by a decrease in platelet levels per unit volume of blood, which can lead to the development of hemorrhagic syndrome. The pathological process in immune thrombocytopenic purpura is based on the breakdown of immunological tolerance to its own antigen. Thrombocytopenic purpura is observed in various age groups. In children, the development of immune thrombocytopenic purpura observed after an infectious disease (influenza, measles, rubella, chickenpox, HIV, etc.), vaccination, and the persistence of viruses (Epstein – Barr, cytomegalovirus, parvovirus B19). Some medications can also cause diabetes: antibiotics, nalidixic acid, trimethoprim, paracetamol, salicylic acid, various nonsteroidal anti-inflammatory drugs, heparin, etc. Objective. The purpose of the publication of this clinical case is to familiarize the medical community with the development of purpura in children after viral infections (from the Herpesviridae), as well as, most importantly, against the background of the recent epidemic of a new type of coronavirus infection (COVID-19). Raising awareness about the possible development of thrombocytopenic conditions in children will allow a more thorough approach to diagnosis and treatment, as well as determine the vector of observation of such patients after diseases in order to prevent the development of life-threatening bleeding with the progression of thrombocytopenia.

Materials and methods. The patient (aged 13) suffered from immune thrombocytopenic purpura: Data from a clinical examination, the results of clinical and instrumental studies were used. Information about the history of life and disease is presented in detail.

Results. The described case of immune thrombocytopenic purpura was probably associated with a new type of coronavirus infection, as well as infection with Epstein – Barr virus. The data presented in the observation correlate with foreign and domestic publications, which emphasizes the importance of timely diagnosis and treatment of viral infections that can cause the development of hematological disorders in childhood.

Conclusion. Given the variability and large number of trigger agents for immune thrombocytopenic purpura, it is necessary to raise awareness of the medical community about the possible causes of immune thrombocytopenic purpura. Timely diagnosis, an integrated approach and therapy are reliable assistants in the practice of a doctor, contributing to achieving stable remission and avoiding relapses of the disease.

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