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Epidermolysis Bullosa Acquisita in a patient with End Stage Renal Disease: Case study.
Umar, Rana Muhammad; Khan, Azhar Ali; Ahmad, Waqar.
  • Umar RM; Department of Nephrology, National Institute of Kidney Diseases, Shaikh Zayed Hospital, Lahore, Pakistan.
  • Khan AA; Department of Nephrology, National Institute of Kidney Diseases, Shaikh Zayed Hospital, Lahore, Pakistan.
  • Ahmad W; Department of Nephrology, National Institute of Kidney Diseases, Shaikh Zayed Hospital, Lahore, Pakistan.
J Pak Med Assoc ; 73(2): 405-406, 2023 Feb.
Article in English | MEDLINE | ID: covidwho-2284868
ABSTRACT
The clinical presentation of COVID-19 varies from being asymptomatic to developing acute respiratory distress syndrome and multi-organ dysfunction. The diffuse microvascular thrombi in multiple organs seen in the autopsy of COVID-19 patients are similar to that of thrombotic microangiopathy (TMA). TMA is characterised by thrombus formation in the microvasculature with laboratory findings of microangiopathic haemolytic anaemia (MAHA) and thrombocytopenia. A 49-year-old male presented to the Aga Khan University Hospital, Karachi. with fever, diarrhoea, altered level of consciousness, and a positive nasopharyngeal swab for SARS-CoV-2. He developed severe thrombocytopenia, MAHA with 5.8% schistocytes, and worsening renal function on the sixth day of admission. Diagnosis of thrombotic thrombocytopenic purpura (TTP) was established based on PLASMIC score, and he was successfully treated with intravenous (IV) Methylprednisolone, therapeutic plasma exchange and IV Rituximab. The case emphasises the need to keep TTP in the differential diagnosis when a patient with COVID-19 develops severe thrombocytopenia, acute renal failure, or impaired level of consciousness, since prompt diagnosis and treatment is necessary to gain favourable outcome.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Purpura, Thrombotic Thrombocytopenic / Epidermolysis Bullosa Acquisita / COVID-19 / Kidney Failure, Chronic Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal: J Pak Med Assoc Year: 2023 Document Type: Article Affiliation country: JPMA.4992

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Purpura, Thrombotic Thrombocytopenic / Epidermolysis Bullosa Acquisita / COVID-19 / Kidney Failure, Chronic Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Humans / Male / Middle aged Language: English Journal: J Pak Med Assoc Year: 2023 Document Type: Article Affiliation country: JPMA.4992