Your browser doesn't support javascript.
Immune thrombocytopenia and COVID-19: Case report and review of literature.
Alonso-Beato, Rubén; Morales-Ortega, Alejandro; Fernández, Francisco Javier De la Hera; Morón, Ana Isabel Parejo; Ríos-Fernández, Raquel; Rubio, José Luis Callejas; Centeno, Norberto Ortego.
  • Alonso-Beato R; Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Morales-Ortega A; Internal Medicine Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain.
  • Fernández FJH; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Hospital, Universitario Clínico San Cecilio, Granada, Spain.
  • Morón AIP; Internal Medicine Department Hospital, Universitario Clínico San Cecilio, Granada, Spain.
  • Ríos-Fernández R; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Hospital, Universitario Clínico San Cecilio, Granada, Spain.
  • Rubio JLC; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Hospital, Universitario Clínico San Cecilio, Granada, Spain.
  • Centeno NO; Faculty of Medicine, University of Granada, Granada, Spain.
Lupus ; 30(9): 1515-1521, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1247525
ABSTRACT
Immune thrombocytopenia, also known as immune thrombocytopenic purpura (ITP), has been reported as an important complication related to COVID-19.We present a 49-year-old male patient with systemic lupus erythematosus with lupus nephritis, antiphospholipid syndrome and history of ITP who developed an ITP flare in the context of COVID-19. He had no bleeding manifestations and had a good response to prednisone treatment.We review the characteristics of the cases reported to date in the literature, with an analysis of 57 patients. Mean age was 56 years (±19.6 SD), and 50.9% were male. This was the first episode of ITP in most of the patients (86.05%), with SARS-CoV-2 acting as the initial trigger. We found that ITP flares may appear in both mild and severe COVID-19 cases. They also appeared at any time during the course of the disease, 48.2% of patients developed it during hospitalization, while it was diagnosed at admission in the rest of the cases. Platelet counts were significantly lower than other ITP series, with a median nadir platelet count of 8 × 109/L (IQR 2-17.75 × 109/L). These patients show a higher bleeding rate (61.4%) compared with other ITP series. They also show a better response to treatment, with good response to the first line therapies in 76.9% of them. The most common first-line treatment was intravenous immunoglobulin (IVIG), used alone or combined with corticosteroids in 40.4% and 32.7% of cases respectively, while 25% of patients received only corticosteroids.Our review suggests that COVID-19-related ITP can be seen even in previously healthy patients. Clinicians must be aware that ITP may appear both in mild and severe COVID-19, at any time during its course. Given that this kind of ITP seems to be associated with a higher bleeding risk, its diagnosis in a clinical scenario such as COVID-19, where anticoagulant therapy is frequently used, may be critical. Treatment with IVIG and/or corticoids is often effective.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Prednisone / Purpura, Thrombocytopenic, Idiopathic / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal: Lupus Journal subject: Rheumatology Year: 2021 Document Type: Article Affiliation country: 09612033211021161

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Prednisone / Purpura, Thrombocytopenic, Idiopathic / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal: Lupus Journal subject: Rheumatology Year: 2021 Document Type: Article Affiliation country: 09612033211021161