COVID-19 presenting as thrombotic thrombocytopenic purpura (TTP).
BMJ Case Rep
; 13(12)2020 Dec 17.
Article
in English
| MEDLINE | ID: covidwho-991776
ABSTRACT
We present the case of a 39-year-old man with epigastric pain, nausea and vomiting. The patient scored 4 in the Visual Triage Checklist of acute respiratory symptoms; a COVID-19 swab was taken. Prompt review of the peripheral blood smear showed evidence of microangiopathic haemolytic anaemia and thrombocytopenia. Because the patient had a picture of thrombotic thrombocytopenic purpura, plasma exchange and corticosteroids were started immediately. After 3 days, he developed severe ischaemic stroke and his swabs came back positive for COVID-19 by reverse transcription PCR. Therefore, triple therapy was started (lopinavir/ritonavir, ribavirin and interferon beta-1b). White blood cell count reached 50×109/L (normal range, 4.5-11×109/L), mainly neutrophils. All the workup for autoimmune diseases was negative. The patient showed delayed improvement in lactate dehydrogenase, haemoglobin and platelet count until we increased the volume of plasma exchange and subsided the inflammatory response of COVID-19. After that, the patient showed an excellent recovery.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Purpura, Thrombotic Thrombocytopenic
/
Ischemic Stroke
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Humans
/
Male
Language:
English
Year:
2020
Document Type:
Article
Affiliation country:
Bcr-2020-238026
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