In Reply: Thrombocytopenia and Pediatric Patients With AIDS

Based upon newly analyzed data, we agree with Dr Weinblatt's well-made point that HIV disease cannot be solely attributed to autoimmune destruction on the basis of elevated levels of platelet-associated IgG. In a recent prospective study of 38 infants and children with HIV infection monitored for as many as 9 years, we demonstrated that, using elevated platelet-associated IgG levels to detect AIDS thrombocytopenia, the sensitivity is 93% but the specificity is 13%. However, when combined with the finding of large circulating platelets as measured by increased mean platelet volume, the specificity is increased to 90%.