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Thrombocytopenia after bacille Calmette-Guerin immunization--possibly on an immune basis.

We report a rare case of AITP in a 5-week-old male infant with IgM and IgG antiplatelet antibodies and an absence of megakaryocytes in the bone marrow. Although the etiology of the condition remains uncertain, the thrombocytopenia could have been a consequence of an inappropriate immune response to a BCG vaccination at birth. Perhaps molecular mimicry (cross-antigenicity between mycobacterium tuberculosis and human platelet antigens) might be an explanation for AITP during tuberculosis infection and after a BCG vaccination. Our patient has responded well to high-doses of methylprednisolone, but we must bear inmind that if there was a transient bonemarrow suppression due to BCG vaccine or a minor intercurrent viral infection, thrombocytopenia and reduced megakaryocytes in the bone marrow could have recovered with time, irrespective of the administration of immunoglobulins or steroids.

thrombocytopenia; Bacille Calmette-Guerin; immunization

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