tetano
Editor, Senior Moderator
Ann Med Surg (Lond)
. 2021 Dec;72:103097.
doi: 10.1016/j.amsu.2021.103097. Epub 2021 Nov 22.
A rare case of absolute thrombocytopaenia in a COVID-19 patient: Case report
Ameen M Mohammad[SUP] 1 [/SUP], Azri S H Sgery[SUP] 2 [/SUP], Nawfal R Hussein[SUP] 3 [/SUP]
Affiliations
Abstract
Introduction: Thrombocytopaenia, one of the most common haematological disorders worldwide, is characterised by platelet counts <150,000/mm[SUP]3[/SUP]. Patients with coronavirus disease (COVID-19) were found to commonly exhibit haematological abnormalities, often with mild forms of thrombocytopaenia. Absolute thrombocytopaenia tends to be rare among these patients and is believed to be secondary to immune-induced thrombocytopaenia.
Case presentation: A 53-y-old man presented with fever and generalised body ache that persisted for a few days. His polymerase chain reaction test was positive for COVID-19, for which he was treated with acetaminophen, levofloxacin, and favipiravir. On the third day of treatment, he noticed bruising and bleeding, mainly in the oral cavity, with clot formation. A complete blood picture (CBP) revealed severe thrombocytopaenia with an almost-zero count. Prednisone 1 mg/kg/d and frequent doses of intravenous platelet transfusion were administered as rescue therapy to prevent fatal bleeding. The patient was able to recover.
Clinical discussion: Immune thrombocytopaenia should be considered in patients presenting with bleeding tendencies after severe acute respiratory syndrome coronavirus 2 infection. Serial CBP is recommended for vulnerable patients, especially during the second and third weeks of hospitalisation, for the early detection and prevention of life-threatening COVID-19 complications.
Conclusions: Absolute thrombocytopaenia is a rare condition. Such a condition should be considered in patients presenting with bleeding tendencies with severe Covid-19 infection. With early diagnosis and appropriate treatment, patients' lives can be saved.
Keywords: COVID-19; Drug-induced immune thrombocytopaenia (DITP); Immune thrombocytopaenia; Immune thrombocytopaenic purpura (ITP); SARS-CoV-2; Thrombocytopaenia.
. 2021 Dec;72:103097.
doi: 10.1016/j.amsu.2021.103097. Epub 2021 Nov 22.
A rare case of absolute thrombocytopaenia in a COVID-19 patient: Case report
Ameen M Mohammad[SUP] 1 [/SUP], Azri S H Sgery[SUP] 2 [/SUP], Nawfal R Hussein[SUP] 3 [/SUP]
Affiliations
- PMID: 34840780
- PMCID: PMC8607684
- DOI: 10.1016/j.amsu.2021.103097
Abstract
Introduction: Thrombocytopaenia, one of the most common haematological disorders worldwide, is characterised by platelet counts <150,000/mm[SUP]3[/SUP]. Patients with coronavirus disease (COVID-19) were found to commonly exhibit haematological abnormalities, often with mild forms of thrombocytopaenia. Absolute thrombocytopaenia tends to be rare among these patients and is believed to be secondary to immune-induced thrombocytopaenia.
Case presentation: A 53-y-old man presented with fever and generalised body ache that persisted for a few days. His polymerase chain reaction test was positive for COVID-19, for which he was treated with acetaminophen, levofloxacin, and favipiravir. On the third day of treatment, he noticed bruising and bleeding, mainly in the oral cavity, with clot formation. A complete blood picture (CBP) revealed severe thrombocytopaenia with an almost-zero count. Prednisone 1 mg/kg/d and frequent doses of intravenous platelet transfusion were administered as rescue therapy to prevent fatal bleeding. The patient was able to recover.
Clinical discussion: Immune thrombocytopaenia should be considered in patients presenting with bleeding tendencies after severe acute respiratory syndrome coronavirus 2 infection. Serial CBP is recommended for vulnerable patients, especially during the second and third weeks of hospitalisation, for the early detection and prevention of life-threatening COVID-19 complications.
Conclusions: Absolute thrombocytopaenia is a rare condition. Such a condition should be considered in patients presenting with bleeding tendencies with severe Covid-19 infection. With early diagnosis and appropriate treatment, patients' lives can be saved.
Keywords: COVID-19; Drug-induced immune thrombocytopaenia (DITP); Immune thrombocytopaenia; Immune thrombocytopaenic purpura (ITP); SARS-CoV-2; Thrombocytopaenia.