Sir.—Rao et al1 reported the case of a child with immune thrombocytopenic purpura (ITP) in whom unusual aseptic meningitis, with greater than 0.90 neutrophils in cerebrospinal fluid, developed within 36 hours of intravenous immune globulin (IVIG) administration. Although the authors stated that "all reported cases of aseptic meningitis occurred in patients with immune thrombocytopenic purpura," it was also observed in adults2 with ITP who were given different preparations of IVIG in different doses.
Although bacterial and viral cultures of cerebrospinal fluid remained negative in those cases (including the authors' patient), this unusual aseptic meningitis could be related to a causative agent (including chemicals) that is not yet known, since the cerebrospinal fluid findings do not fit those of pseudotumor cerebri.
Since the prognosis of acute childhood ITP is very favorable, and, when required, the platelet count can be raised above 150×109/L within 3 days in