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Lupus . Severe Refractory Thrombocytopenia in a Woman Positive for Coronavirus Disease 2019 With Lupus and Antiphospholipid Syndrome

tetano

Editor, Senior Moderator
Lupus


. 2020 Jul 8;961203320940389.
doi: 10.1177/0961203320940389. Online ahead of print.
Severe Refractory Thrombocytopenia in a Woman Positive for Coronavirus Disease 2019 With Lupus and Antiphospholipid Syndrome


Alina Hayden[SUP] 1 [/SUP], Aishwarya Vyas-Lahar[SUP] 1 [/SUP], Vincent Rella[SUP] 2 [/SUP], Alla Rudinskaya[SUP] 3 [/SUP]



Affiliations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has created new challenges that necessitate prompt responses in unexpected clinical situations. Multiple extrapulmonary manifestations and complications of COVID-19 have already been described, but only scattered data are present on immunologic manifestations. We present a case of severe refractory thrombocytopenia in a 51-year-old woman with a history of long-standing systemic lupus erythematosus and antiphospholipid syndrome who presented with hemoptysis in the setting of COVID-19 infection. The patient failed to respond to initial treatment with intravenous immunoglobulin, high-dose steroids, and platelet transfusion, but responded to eltrombopag, with prompt improvement of a platelet count. The current case report provides clinical data of relevance to the largely unexplored question of the immunologic complications of COVID-19 in patients with a pre-existing inflammatory state.

Keywords: COVID-19; antiphospholipid syndrome; immune thrombocytopenia; systemic lupus erythematosus.
 
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