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TOPIC: ITP and overseas travel

ITP and overseas travel 1 year 1 month ago #63198

  • nick2182
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Hey all,

This is a rather broad scenario type of question due to my diagnosis of Glandular Fever/EBV and ITP. I was wondering if anyone has had similar experiences with ITP due to travelling abroad and interactions with locals in what I would call - "developing nations". I'm struggling to understand how I am suffering from ITP and the associated timeline is rather confusing to me...this has been going on for me since 2013 (approx).

In 2013, I was a military member and was deployed to a developing nation for approximately 8 months - during my time there I interacted heavily with local nationals in interview settings - sharing food and drink in small rooms - with the local nationals not having adequate health screenings prior to interview. I conducted this role day in, day out for the entire 8 months.

Approximately 2-3 months of returning home my platelet count dropped to 23 (23,000) - based on information not being given to me regarding my platelet drop, I continued life as normal. 3 years later I was feeling unwell - flu like, swollen glands. I had a blood test and was rushed to emergency with a platelet count of 10 (10,000). After investigation it turned out that I had glandular fever - which I have been told probably triggered the ITP/platelet destruction.

My rather vague question - could I have contracted glandular fever from my interactions with local nationals from 2013, with a culmination of sickness three years later in 2016 which caused the continued platelet destruction (23000 - 10000) over a period of three years, until the time the flu like symptoms caught up with me?? And which came first - the ITP and due to being in a weakened immune state I contracted the EBV - or is it vice versa?

I have had blood tests carried out with most viral/bacterial infections that I can think of with nothing irregular found - other than the Glandular Fever/EBV.
If anyone else has had similar experiences I would love to hear - or if anyone can suggest other illnesses I can be tested for? Thank you.

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ITP and overseas travel 1 year 1 month ago #63201

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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Nick - it appears to me that you had ITP first based on the info that you gave. A platelet count of 23k would indicate thrombocytopenia for sure. I don't know what triggered it, but you should have been told at the time the results came back. Since you weren't told and didn't have any serious symptoms, I guess there was no harm done. Did you have any CBC's done in that three year period?

From what I can see in a quick search, glandular fever is mono and the incubation period is 4 to 6 weeks. Mono is caused by the EBV. I doubt it would have anything to do with your time overseas since mono is common in the US. Mono can cause platelet counts to drop but yours may have already been low. Without CBC results during those three years, it's impossible to know where your counts were prior to the onset of mono.

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ITP and overseas travel 1 year 1 month ago #63215

  • nick2182
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Thanks Sandi - unfortunately no CBC in between periods.

I suppose having a low platelet count/weakened immune system would have assisted me in contracting EBV/mono. Who knows.

Thanks again

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ITP and overseas travel 1 year 1 month ago #63216

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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Having ITP doesn't cause a weak immune system. It's more of a misfire. Both my daughter and husband have had mono. It's not unusual.

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ITP and overseas travel 1 year 1 month ago #63220

  • mrsb04
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From the papers I accessed EBV is world wide. A huge percentage of people are infected with no symptoms. It can lie dormant for years and suddenly trigger into full blown glandular fever .

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ITP and overseas travel 1 year 1 month ago #63226

  • MelA
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nick2182 wrote: In 2013, I was a military member and was deployed to a developing nation for approximately 8 months.

Just curious if being sent to a "developing nation" and in the military if you were given any immunizations/meds/the like
before you were sent there?
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD

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ITP and overseas travel 1 year 1 month ago #63243

  • nick2182
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Hey MelA,

Prior to deployment (from memory) - I had MMR immunisations as well as the usual Hepatitis injections. I have heard immunisations can cause a low platelet count or drug induced ITP. What concerns me is that my platelet count dropped dramatically to 23,000 and continued to fluctuate/drop for the next 3 years until it was identified at 10,000. Seems to me that the immunisations would have not affected me for this long...or am I wrong?

In my mind I'm thinking the following:

I caught EBV/mono during an 8 month deployment which lay dormant/undiagnosed but began attacking my platelets (23,000). 3 years later the EBV was still present/active in my body and fully came out when my glands began swollen/flu like and a platelet count was 10,000.

From people's experiences/study - am I wrong in thinking this? It all just seems too convenient to me and that the likely later diagnosed EBV would have been a factor in the initial 23,000 platelet count?

In short, I have no idea hahhaa. but I thank everyone for their help :)

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ITP and overseas travel 1 year 1 month ago #63244

  • Sandi
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MMR can cause chronic ITP.

Immune thrombocytopaenic purpura (ITP) is an autoimmune systemic disease detectable by the presence of low blood platelets count (<10(5)/µl) and the production of autoantibodies against glycoproteins expressed on the platelet surface. The clinical course is often acute, and life-threatening events may occur especially in children, with 52% of paediatric patients recovering either spontaneously or after treatment. A chronic ITP evolution is observed in 64% of adults, of whom 12% will develop an overlapping autoimmune disease. Several microbial agents such as CagA-positive Helicobacter pylori or Candida albicans and a number of viruses including CMV, EBV or HIV can potentially trigger ITP through molecular mimicry. Moreover, ITP improves after treatment of the underlying infection. Similarly, vaccines such as MMR may prompt ITP (IRR 5.48, 1.61-18.64, p < 0.006). Early recognition of the underlying microbial trigger and the removal of modifiable aetiopathogenetic factors should be integrated as a complementary treatment strategy in all patients who do not readily improve with standard ITP care.

www.ncbi.nlm.nih.gov/pubmed/24763539

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ITP and overseas travel 1 year 1 month ago #63245

  • nick2182
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Thanks Sandi

Could be a double whammy of both MMR immunisations and contracting EBV. Thank you.

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