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Exacerbation of Chronic Idiopathic Thrombocytopenic Purpura Following Measles-Mumps-Rubella Immunization

Richard A. Drachtman, MD; Susan Murphy, MD; Lawrence J. Ettinger, MD
Arch Pediatr Adolesc Med. 1994;148(3):326-327. doi:10.1001/archpedi.1994.02170030096023.
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Idiopathic thrombocytopenic purpura (ITP) is a common childhood disorder in which peripheral thrombocytopenia is associated with an increase in platelet production and a decrease in platelet life span. This is secondary to the binding of IgG to platelets, which results in their destruction by the reticuloendothelial system.1 Eighty-five percent of the cases occur following a viral infection.2 Acute infection with measles or rubella has been reported to result in ITP,3-5 as has immunization with live measles or rubella vaccines.6-9 Current immunization schedules for measles call for reimmunization of all adolescents as well as adults born after 1957 who do not have a clinical history of measles or a measles titer indicative of immunity. Vaccination for rubella is recommended for all susceptible adults.10

Patient Report.  A 19-year-old woman with chronic ITP presented with menorrhagia and bruising with a significant decline in platelet counts 7 weeks after


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