Abstract Number: PB0303
Meeting: ISTH 2021 Congress
Background: During the current COVID-19 pandemic, thrombocytopenia was noted in up to one third of hospitalized patients, being lower in those with very severe disease. In most COVID-19-related thrombocytopenia, the platelet count does not fall below 100×109/L. Severe degree of thrombocytopenia (< 20×109/L, or a sudden drop >50% over 24-48 h) is likely to indicate an immune aetiology.
Aims: We described a rare case of immune thrombocytopenic purpura (ITP) associated with COVID-19.
Methods: Patient medical files were retrospectively reviewed.
Results: A previously healthy 23-year-old woman visited the Emergency Department after 2 days of sneezing, cough, sorethroat, shivers, and fever. She also complained petechiae and spontaneous mild gingival hemorrhage, with a normal blood count. Three days later, she was admitted due to worsening of the petechiae and a drop in the platelet (231.9×109/L to 5.8×109/L). Nasopharynx-swab RT-qPCR detected SARS-CoV-2. Reticulocyte count was normal and no schistocyte was observed. Clotting assays and fibrinogen were normal, and D-dimers were slightly increased. She had microscopic hematuria with normal renal function tests. Total/fractionated bilirubin, and transaminases were normal, although lactic dehydrogenase was slightly elevated. Thyroid function was normal. Protein electrophoresis was normal. Folate and vitamin B12 levels were normal. Anti-nuclear antibodies, syphilis, human immunodeficiency virus, and hepatitis C virus tests were non-reagent. She was immunized against hepatitis B virus. Anticardiolipin antibodies were negative, but direct Coombs and lupus anticoagulant tests were positive. Thoracic computed tomography was normal. Prednisone was administered and she was discharged home with a platelet count of 191.9×109/L. Two months after prednisone withdrawal, direct Coombs and lupus anticoagulant tests were negative, while platelets were 354.0×109/L.
Conclusions: Although thrombocytopenia may be a predictor of worse prognosis in COVID-19, no relationship between ITP and outcome was described yet. Currently, after excluding other causes of (severe) thrombocytopenia, the treatment of COVID-19-associated ITP should be similar the treatment of non-COVID-19 individuals.
To cite this abstract in AMA style:Camelo RM, Gontijo PC. Immune Thrombocytopenia Purpura Associated with Novel Coronavirus Infection [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/immune-thrombocytopenia-purpura-associated-with-novel-coronavirus-infection/. Accessed September 16, 2021.
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