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Suggest Treatment For Idiopathic Thrombocytopenic Purpura
Question: For the past 2 1/2 yrs. i have low platelets,between 45,000-80,000. I had numerous test including a bone marrow biopsy and was told that besides my ITP i have EBV greater than 5. In the beginning i have had abdominal pain w/vomiting then 6 months later feet/hand pain,chancre sores,tingling in the hands and forearms,Itching all over body without a rash. My question is 1.) Can a chronic case of EBV cause all these symptoms still after 2 1/2 yrs and seem to get worse? 2.) i tested for Bone-marrow,upper-scope,colonoscopy,hepatitis,hiv,lupus,lymes, all coming back neg. The hiv ab 1&2 was just under 3 months after sexual encounter with person of unknown status and came back neg. Is that neg. result conclusive? 3.) I also tested for hiv pcr rna at 3 months after risk that was also non-reactive. Is this enough time to confirm my results? 4.) I've read that sometimes the (Window Period) seroconversion can take up to 6 months to a year before antibodies can be detected.Is this true or is three months enough time? 5.) At 1 , 1 1/2 and 2yrs. i did an at home Oraquick hiv saliva test that also came back neg. each time. Are these reliable test results after the window period or should another blood test be taken? 6.) There has been no sexual encounters/risk at all since the initial 2 1/2 yrs ago. But the symptoms have progressed thru out.The current symptoms are tingling all over w/no visible rash,low platelets and an occasional chancre sore in the mouth,stiff neck. Is there anything else you think i should look for since my symptoms seem to be progressing over the past 2 1/2 yrs? We've eliminated so many possibilities and i'm wondering if we need to retest any of the test above . thank you
Brief Answer:
There is possibility of EBV infection
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
I will take up your queries one by one.
1. Idiopathic thrombocytopenic purpura (ITP) can become chronic when the disease continues for more than six months. When it becomes chronic, appropriate therapy consisting of immunosuppressives are used. You have not mentioned whether you have been given this treatment in the past. An immunosuppressive therapy will bring the platelet levels to normal range.
2. HIV 1 and 2 infections can remain undetectable for three months after exposure to HIV. This is the window period. The test for HIV should be repeated after three months of exposure and if it remains negative, it should be done after six months. If the test still remains negative, then the test is definitely non-reactive or negative.
As a prevention, high risk sexual behaviour should be avoided in future.
3. EBV infection can cause a number of diseases like infectious mononucleosis, lymphomas and other malignancies.
Besides these disease processes EBV like other viral infections can cause a suppression of platelets.
EBV infection is detected by serological tests and as you have mentioned the test for EBV is elevated, thus there is strong possibility that the suppression of platelets is due to viral infection.
You need to get treatment for EBV infection.
Consult need to consult your physician for further treatment.
If you have more queries I will be glad to answer.
Dr Shailja P Wahal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you for your quick response! a couple more questions 1.) is the hiv pcr taken at 3 months coming back non-reactive/undectable conclusive due to the sensitivity of the test or is it still necessary for the 6 month test? 2.) is the at home Oraquick saliva test reliable at year later and another at 1 1/2 and 2 with no other risk? Can i count on this type of test or do i need a blood test? Can the Oraquick siliva give a false neg.? I've done at least 5 of those test 3.) When i tested positive for EBV greater than 5,can that be mistaken for hiv or the ebv test specific to ONLY that virus? 4.) If ebb is the cause of all my problems ,is it possibly to develop itchy skin or rash 1 or 2 years later after the initial infection? I was given no treatment for ebv as it is a recent discovery after 2 years of trying to do process of elimination. I was unaware that anything could be done with ebv, my understanding is that there is no specific treatment for it and the virus is in you forever! thanks
Brief Answer:
Treatment of EBV is available
Detailed Answer:
Hello and welcome again,
1. A non-reactive HIV test at three months rules out HIV infection for all practical purposes, however, to confirm the results you can repeat the test.
2. The saliva test is specific for EBV infection and it will not cross-react with HIV infection.
3. Treatment is available for EBV which will clear the infection from blood. The infection will not stay in body for rest of life.
4. Rash on the body can be due to EBV infection.
Thanks and take care.
Dr Shailja P Wahal
Above answer was peer-reviewed by :
Dr. Raju A.T
My last questions here 1.)Sorry i may not have been clear but my question for the saliva test was the Oraquick HIV test not for ebv. Is the saliva test for HIV reliable at 1, 1 1/2 & 2 yrs for confirmation for a neg. result or should the confirmation test be a blood test? The only blood test i did was at 3 months hiv ab 1&2 and the pcr rna viral load,any other test have been the Oraquick at home test.i just want to be able to clear my mind and fears of hiv. 2.) if ebv has been the problem since the beginning do i remain contagious since there has been no treatment for that thus far? 3.) what type or treatment do i seek for EBV? is there shots or pills to take to help clear up the EBV infection/ thanks again
Brief Answer:
EBV treatment consists of anti-viral pills
Detailed Answer:
Hello and welcome again,
The treatment of EBV infection is anti-viral therapy which is the form of pills.
If you are positive for EBV, it remains contagious.
A negative PCR test for EBV rules out the HIV infection.
Thanks and take care,
Dr Shailja P Wahal
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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