Thrombocytopenia in Epstein-Barr Virus Infection as A Hidden Clinical Clue

Thrombocytopenia is a frequently overlooked yet clinically relevant manifestation of Epstein-Barr virus (EBV) infection, particularly in children. Although it is commonly associated with EBV-related conditions, thrombocytopenia is often misdiagnosed as primary immune thrombocytopenia or dismissed as an incidental finding. This review summarizes current evidence linking EBV infection and thrombocytopenia, highlighting its potential as an early clinical clue. We emphasize the importance of timely EBV testing in pediatric patients with unexplained thrombocytopenia and advocate for greater clinical awareness and multidisciplinary research. Recognizing thrombocytopenia as more than a minor laboratory abnormality may improve diagnostic accuracy, guide appropriate treatment, and inform future research directions.