Severe immune thrombocytopenia possibly elicited by the anti-influenza viral agent peramivir

Intern Med. 2014;53(20):2369-71. doi: 10.2169/internalmedicine.53.2330. Epub 2014 Oct 15.

Abstract

A 44-year-old man whose platelet count had been at the lower limit of the normal range for years visited the urgent care department of our hospital for treatment of a high fever and severe fatigue. The influenza A virus was detected, and the patient therefore received the intravenous antiviral agent, peramivir. One week later, he developed systemic petechial rashes. A peripheral blood examination showed a markedly decreased platelet count (3.0×10(9) cells/L), and the bone marrow findings were compatible with a diagnosis of immune thrombocytopenia (ITP). Furthermore, a drug-induced lymphocyte-stimulating test was positive for peramivir. The thrombocytopenia slowly responded to treatment with oral prednisolone. This case suggests that neuraminidase inhibitors, including peramivir, can elicit or worsen ITP.

Publication types

  • Case Reports

MeSH terms

  • Acids, Carbocyclic
  • Adult
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Cyclopentanes / adverse effects*
  • Cyclopentanes / therapeutic use
  • Guanidines / adverse effects*
  • Guanidines / therapeutic use
  • Humans
  • Influenza A virus
  • Influenza, Human / drug therapy
  • Male
  • Platelet Count
  • Prednisolone / therapeutic use
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / immunology

Substances

  • Acids, Carbocyclic
  • Antiviral Agents
  • Cyclopentanes
  • Guanidines
  • Prednisolone
  • peramivir