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Archives de pédiatrie
Volume 12, n° 3
pages 281-283 (mars 2005)
Doi : 10.1016/j.arcped.2004.11.017
Received : 14 November 2003 ;  accepted : 12 November 2004
Purpura thrombopénique à parvovirus B19 compliqué d'hémorragie cérébroméningée
Parvovirus B19 thrombocytopenic purpura complicated with a cerebral hemorrhage
 

P. Tourneux a, , P. Jouvencel b, M. Micheau c, A.C. Jouvencel d, J.F. Chateil e, G. Barba b, B. Letavernier b, B. Llanas b
a Service de médecine néonatale et réanimation pédiatrique polyvalente, CHU d'Amiens, hôpital Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France 
b Département de pédiatrie, CHU de Bordeaux, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France 
c Laboratoire d'hématologie, CHU de Bordeaux, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France 
d Laboratoire de virologie, CHU de Bordeaux, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France 
e Service de radiologie pédiatrique, CHU de Bordeaux, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France 

*Auteur correspondant.
Résumé

Les complications hémorragiques sévères du purpura thrombopénique idiopathique étant rares, cette affection est considérée le plus souvent comme bénigne.

Observation. - Nous rapportons le cas clinique d'un enfant de quatre ans ayant présenté un purpura thrombopénique à parvovirus B19. Malgré l'utilisation précoce et répétée d'immunoglobulines polyvalentes, l'évolution a été caractérisée par l'apparition secondaire d'une hémorragie cérébrale, responsable du décès de l'enfant sept jours après le diagnostic initial.

Commentaires. - Il semble justifié de rechercher systématiquement le parvovirus B19 par PCR dans le diagnostic étiologique d'un purpura thrombopénique idiopathique. L'aspect imprévisible des complications hémorragiques graves, en particulier cérébrales, rend compte de la gravité potentielle de cette maladie.

The full text of this article is available in PDF format.
Abstract

Severe hemorrhage complications are rare in idiopathic thrombocytopenic purpura. This pathology is often considered as benign.

Case report. - We report the case of a four-year-old boy presenting a parvovirus B19 idiopathic thrombocytopenic purpura. Despite early and repeated use of intravenous immunoglobulin, the evolution was characterized by the secondary apparition of a cerebral hemorrhage. It was lethal seven days after the initial diagnosis.

Conclusion. - Parvovirus B19 should be investigated as an etiologic agent of idiopathic thrombocytopenic purpura, using PCR. The unpredictive aspect of severe hemorrhage complications, especially cerebral hemorrhages, explains the potential severity of this disease.

The full text of this article is available in PDF format.

Mots clés : Purpura thrombopénique, Hémorragie cérébrale, Parvovirus B19, Immunoglobulines

Keywords : Thrombocytopenic purpura, Cerebral hemorrhage, Parvovirus B19, Child, Immunoglobulins




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