The role of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in immune thrombocytopenia

Abstract
Although Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are known to trigger immune thrombocytopenia (ITP), the manifestations of EBV and CMV in ITP spleen tissues continue to be poorly understood. Our research retrospectively reviewed a total of 42 ITP patients and 20 healthy control cases from the West China Hospital of Sichuan University from 2008 to 2012. Patients' characteristics, preoperative platelet counts, and the expression of EBV and CMV in spleen tissue were analyzed. No statistically significant differences were identified for age and gender between the ITP group and the healthy control group. The comparison of these two categories (the ITP group and the control group) showed substantial variations in the expression of EBV and CMV: nine (21.4%) and eight (19%) ITP patients had a positive expression of EBV and CMV, compared with none and one patient in the control group, respectively. In the EBV-ITP group, patients with a positive EBV expression revealed appreciably decreased preoperative platelet count compared with patients with a negative EBV expression. No other statistically significant difference was found in the CMV group. We have demonstrated the presence of both EBV and CMV infections in the spleen tissue of ITP patients. EBV infections were implicated in the reduced platelet counts in ITP.