RESUMEN
Inflammatory bowel disease and paroxysmal nocturnal hemoglobinuria (PNH) are both well-known prothrombotic states. However, ongoing thromboprophylaxis is usually effective in such conditions. We report an imbalance that was triggered by COVID-19 infection. There is evidence that COVID-19 infection leads to thrombosis of vessels. The thrombosis of mesenteric vessels can be multifocal and without respiratory symptoms and leads to devastating consequences like resection of large segments of the bowel and lifelong requirement of parenteral nutritional support. We report about a case of ulcerative colitis (in remission) and PNH where COVID-19 resulted in mesenteric ischemia.
Asunto(s)
COVID-19 , Colitis Ulcerosa , Hemoglobinuria Paroxística , Isquemia Mesentérica , Trombosis , Tromboembolia Venosa , Humanos , Anticoagulantes/uso terapéutico , Isquemia Mesentérica/etiología , Isquemia Mesentérica/tratamiento farmacológico , Hemoglobinuria Paroxística/complicaciones , Hemoglobinuria Paroxística/diagnóstico , Hemoglobinuria Paroxística/tratamiento farmacológico , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/tratamiento farmacológico , COVID-19/complicaciones , Tromboembolia Venosa/tratamiento farmacológico , Trombosis/etiología , Trombosis/tratamiento farmacológicoRESUMEN
During an acute SARS-CoV-2 infection, a diagnosis of Aplastic Anaemia associated with Paroxysmal Nocturnal Haemoglobinuria (AA/PNH) was made in a 78-year-old woman who had presented to the emergency department with severe pancytopenia. It is possible that she had subclinical AA/PNH that was unmasked during the acute COVID-19 infection, but we can also suspect a direct role of the virus in the pathogenesis of the disease, or we can hypothesize that COVID-19 infection changed the phosphatidylinositol glycan class A (PIGA) gene pathway.