Abstract
Varicella zoster infection in children can be complicated by acute idiopathic thrombocytopenic purpura (ITP). To determine the etiologic mechanism of this thrombocytopenia, we studied three children with clinically diagnosed varicella infection. Immunoblot analysis of these patients' anti-platelet antibodies identified a unique band at 85 kD. Characterization of this protein revealed that it was platelet surface glycoprotein V (GPV) because it was not affected by a disulfide bond reduction but was cleaved by thrombin. Bernard-Soulier syndrome (BSS) platelets deficient in GPIb-IX and GPV did not react with the sera from our varicella-infected study patients. There was no apparent cross-reactivity between anti-varicella antibody and patients' anti-GPV Ig. We report here the first cases of GPV as the target antigen in autoimmune thrombocytopenia.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- ITP:
-
idiopathic thrombocytopenic purpura
- GP:
-
glycoprotein
- BSS:
-
Bernard-Soulier syndrome
- IVIgG:
-
i.v. gamma globulin
References
Fernbach DJ 1973 Bleeding and Infection. Am J Dis Child 125: 900
Ho-Yen Do, Hardie R, Sommerville RG 1984 Varicella-induced thrombocytopenia. J Infect 8: 274–276
Smith H 1967 Pupura fulminans complicating varicella: recovery with low molecular weight dextran and steroids. Med J Aust 2: 685–687
Ware R, Kurtzberg J, Friedman HS, Falletta JM, Kinney TR 1988 Chronic immunemediated thrombocytopenia after varicella infection. J Pediatr 112: 742–744
Yeager AM, Zinkham WH 1980 Varicella-associated thrombocytopenia: clues to the etiology of childhood idiopathic thrombocytopenic purpura. Johns Hopkins Med J 146: 270–274
McKay DG, Margaretten W 1967 Disseminated intravascular coagulation in virus diseases. Arch Intern Med 120: 129–152
Jerushalmy Z, Kohn A, deVries A 1961 Interaction of myxoviruses with human blood platelets in vitro. Proc Soc Exp Biol Med 106: 462–466
Terada H, Baldini M, Ebbe S, Madoff MA 1966 Interaction of influenza virus with blood platelets. Blood 28: 213–228
Espinoza C, Kuhn C 1974 Viral infection of megakaryocytes in varicella with purpura. Am J Clin Pathol 61: 203–208
Scott S, Reimers HJ, Chernesky MA, Greenberg JP, Kinlough-Rathbone RL, Packham MA, Mustard JF 1978 Effect of viruses on platelet aggregation and platelet survival in rabbits. Blood 52: 47–55
Feusner JH, Slichter SJ, Harker LA 1979 Mechanisms of thrombocytopenia in varicella. Am J Hematol 7: 255–264
Winiarski J 1989 Platelet antigens in varicella associated thrombocytopenia. Arch Dis Child 65: 137–139
Harper DR, Grose C 1989 IgM and IgG Responses to varicella-zoster virus p32/p36 complex after chickenpox and zoster, congenital and subclinical infections, and vaccination. J Infect Dis 159: 444–451
Laemmli UK 1970 Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 227: 680–685
Towbin H, Staehlin T, Gordon J 1979 Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets: procedure and some applications. Proc Natl Acad Sci USA 76: 4350–4354
Beardsley DS, Spiegel JE, Jacobs MM, Handin RI, Lux SE 1984 Platelet membrane glycoprotein IIIa contains target antigens that bind anti-platelet antibodies in immune thrombocytopenia. J Clin Invest 74: 1701–1707
Berndt MC, Phillips DR 1981 Purification and preliminary physicochemical Characterization of human platelet membrane glycoprotein V. J Biol Chem 256: 59–65
Phillips DR, Agin PP 1977 Platelet plasma membrane glycoproteins: identification of a proteolytic substrate for thrombin. Biochem Biophys Res Commun 75: 940–947
Modderman PW, Admiraal LG, Sonnenberg A, Von dem Bonne AEGK 1992 Glycoproteins V and Ib-IX form a noncovalent complex in the platelet membrane. J Biol Chem 267: 364–369
Roth GJ, Church TA, McMullen BA, Williams SA 1990 Human platelet glycoprotein V: a surface leucine-rich glycoprotein related to adhesion. Biochem Biophys Res Commun 170: 153–161
Wright JF, Blanchette VS, Freedman J 1994 Virus-reactive antibodies cross-react with autologous platelets in a patient with varicella zoster virus (VZV)-associated idiopathic thrombocytopenic purpura (ITP). Blood 84( suppl): 185a.
Meenaghan M, Judson PA, Yousaf K, Lewis L, Pamphilon DH 1993 Antibodies to platelet glycoprotein V in polytransfused patients with haematologic diseases. Vox Sang 64: 167–170
Ertem M, Moulton T, Ho JS, Beardsley DS 1994 A new platelet alloantigen, P1T, on glycoprotein V associated with neonatal alloimmune thrombocytopenia. Pediatr Res 35: 160A
He R, Reid DM, Jones CE, Shulman WR 1994 Spectrum of Ig classes, specificities, and titers of serum antiglycoproteins in chronic idiopathic thrombocytopenic purpura. Blood 83: 1024–1032
Acknowledgements
The authors gratefully acknowledge the laboratory assistance of Joyce S. Ho, the generous gift of BSS platelets from Dr. Leonard Small, Dover, NH, the varicella viral proteins kindly supplied by Dr. Charles Grose, University of Iowa School of Medicine, Iowa City, IA, and the secretarial assistance of Lynn Puglisi, Pat Spica, and Heidi Zeitler.
Author information
Authors and Affiliations
Additional information
Supported in part by National Institutes of Health Grants HL01485 and HL38579 (to D.S.B.).
Rights and permissions
About this article
Cite this article
Mayer, J., Beardsley, D. Varicella-Associated Thrombocytopenia: Autoantibodies against Platelet Surface Glycoprotein V. Pediatr Res 40, 615–619 (1996). https://doi.org/10.1203/00006450-199610000-00017
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/00006450-199610000-00017
This article is cited by
-
Relapse of idiopathic thrombocytopenic purpura caused by influenza A virus infection: a case report
Journal of Infection and Chemotherapy (2004)
