Herpes zoster-associated idiopathic thrombocytopenic purpura in a liver transplant recipient: a case report and overview

Idiopathic (autoimmune) thrombocytopenic purpura has been previously reported as a rare complication in children and in a few adults following chickenpox. We report a case of varicella zoster virus-associated idiopathic thrombocytopenic purpura in an adult liver transplant recipient following dermatomal zoster. Idiopathic thrombocytopenic purpura developed 3 days after the onset of herpes zoster in our patient, with a nadir platelet count of 3000/mm³. The patient was treated with intravenous gamma globulin with recovery of thrombocytopenia after 3 weeks. Transplant clinicians need to be aware that this serious and potentially life-threatening complication may occur with herpes zoster in transplant recipients.