scholarly journals Severe immune thrombocytopenic purpura after SARS-CoV-2 vaccine

2021 ◽  
Vol 8 (2) ◽  
pp. 31-36
Author(s):  
Katherine Cooper ◽  
Bradley Switzer
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Laboratory Tests ◽  
The United States ◽  
Severe Thrombocytopenia ◽  
Thrombocytopenic Purpura ◽  
Intravenous Immunoglobulin G ◽  
Response Prompting ◽  
Low Platelet Count ◽  
Work Up

Immune thrombocytopenic purpura (ITP) is a rare hematologic condition through to affect 3.3 in 100,000 adults per year in the United States. Many cases of immune thrombocytopenia are diagnosed incidentally with laboratory tests that reveal low platelet count, without a clear cause. However, when platelet counts are very low, patients may show signs of bleeding. Here we present the case of a 24-year-old female with mucocutaneous bleeding ten days after receiving her first dose of SARS-CoV-2 vaccine, who was subsequently found to have severe thrombocytopenia. Extensive work up for new thrombocytopenia was unremarkable suggesting a diagnosis of ITP, potentially secondary to vaccination. Empiric treatment with glucocorticoids was initiated without response prompting the use of intravenous immunoglobulin G. The patient was discharged on hospital day five with a platelet count over 20,000 platelets per microliter. In summary, ITP is a potential sequela of the SARS-CoV-2 vaccine, and otherwise healthy young individuals may be at risk for hematologic side effects.

scholarly journals Severe Immune Thrombocytopenic Purpura Treated with Plasma Exchange

2012 ◽  
Vol 10 (1) ◽  
pp. 77-82 ◽  
Author(s):  
MR Sigdel ◽  
DS Shah ◽  
MP Kafle ◽  
KB Raut
Keyword(s):  
Platelet Count ◽  
Plasma Exchange ◽  
Immune Thrombocytopenic Purpura ◽  
Low Dose ◽  
High Dose ◽  
Severe Thrombocytopenia ◽  
First Line ◽  
Thrombocytopenic Purpura ◽  
Steroid Resistant ◽  
Low Platelet Count

Immune thrombocytopenic purpura (ITP) is a hematological disorder characterized by immunologically mediated destruction of platelets and absence of other causes of thrombocytopenia. Treatment is required when the low platelet count entails risk of serious bleeding. Steroid is the first line of management. Acute refractory ITP with very low platelet count is variably treated with high dose steroid, intravenous immunoglobulin (IVIg), anti D or emergency splenectomy. Here, we present a case of steroid resistant ITP with severe thrombocytopenia treated with plasma exchange and low dose IVIg who responded dramatically to the therapy with maintained platelet count till one month from the institution of therapy. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 85-87 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6922

scholarly journals Metastatic Breast Cancer with Extensive Osseous Metastasis Presenting with Symptomatic Immune Thrombocytopenic Purpura and Anemia: A Case Report and Review of the Literature

2015 ◽  
Vol 8 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Jiaxin Niu ◽  
Teresa Goldin ◽  
Maurie Markman ◽  
Madappa N. Kundranda
Keyword(s):  
Breast Cancer ◽  
Platelet Count ◽  
Metastatic Breast Cancer ◽  
Immune Thrombocytopenic Purpura ◽  
English Literature ◽  
Metastatic Breast ◽  
Response To Therapy ◽  
Severe Thrombocytopenia ◽  
Thrombocytopenic Purpura ◽  
Immune Mediated

Background: Immune thrombocytopenic purpura (ITP) is a rare acquired bleeding disorder with an estimated incidence of 1 in 10,000 people in the general population. The association of ITP with breast cancer is an even rarer entity with very limited reports in the English literature. Case Presentation: We report a case of a 51-year-old female with no significant past medical history who presented with sudden onset of malaise, syncope, gingival bleed and epistaxis. She was found to have severe thrombocytopenia (platelet count 6,000/μl) and anemia (hemoglobin 7.2 g/dl). Her workup led to the diagnosis of metastatic ductal breast cancer with extensive bone metastasis. Bone marrow biopsy demonstrated myelophthisis which was initially thought to be consistent with her presentation of thrombocytopenia and anemia. Therefore, the patient was started on hormonal therapy for the treatment of her metastatic breast cancer. After 3 months of therapy, she did not improve and developed severe mucosal bleeding. Her clinical presentation was suspicious for ITP and immune-mediated anemia, and hence she was started on steroids and intravenous immunoglobulin. The patient had a dramatic response to therapy with normalization of her platelet count and hemoglobin within 2 weeks. Conclusion: To our knowledge, this is the first reported case of metastatic breast cancer presenting with symptomatic ITP and anemia, and both symptoms are postulated to be immune-mediated.

scholarly journals A rare presentation of immune thrombocytopenic purpura

2021 ◽  
Vol 9 (12) ◽  
pp. 3692
Author(s):  
Ponvijaya Yadav ◽  
Vijayashree S. Gokhale ◽  
Rupesh Parati ◽  
Keyuri Mehta
Keyword(s):  
Platelet Count ◽  
Lupus Erythematosus ◽  
Immune Thrombocytopenic Purpura ◽  
Liver Function Tests ◽  
Bone Marrow Examination ◽  
Severe Thrombocytopenia ◽  
Rare Presentation ◽  
Thrombocytopenic Purpura ◽  
Hematologic Disorder

Immune thrombocytopenic purpura (ITP) is defined as a hematologic disorder, characterized by isolated thrombocytopenia without any apparent cause. Some patients may be diagnosed during routine blood investigations or may present with bleeding diathesis. Treatment required for moderate to severe thrombocytopenia or those with bleeding manifestations. We present a case of 43 year old male, sputum positive pulmonary tuberculosis on isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E) (HRZE) with persistent thrombocytopenia. He developed hepatitis hence isoniazid (INH) and rifampicin were stopped. He had fever, rash, purpura, hematuria and blood tinged sputum with platelet count of 10,000. 4 random donor platelets (RDPs) given. He suffered from mild COVID-19 infection and recovered in 2 weeks but platelets remained low. Bone marrow examination was suggestive of ITP. Inspite of steroid therapy no improvement was seen. Later was treated with injection romiplostim, and started on systemic lupus erythematosus (SLE) regimen for tuberculosis and discharged with regular follow up. Last platelet count being 1,20000/dl, liver function tests normal and now restarted on HRZE.

scholarly journals Total Hip Arthroplasty for Rapidly Destructive Coxarthrosis in a Patient with Severe Platelet Deficiency due to Liver Cirrhosis and Immune Thrombocytopenic Purpura

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Shunpei Hama ◽  
Fumiaki Inori ◽  
Dai Momose ◽  
Sadahiko Konishi
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Immune Thrombocytopenic Purpura ◽  
Elderly Women ◽  
Thrombocytopenic Purpura ◽  
Total Hip ◽  
Low Platelet Count ◽  
Rapidly Destructive Coxarthrosis

Rapidly destructive coxarthrosis (RDC) causes rapid and extreme destruction of the hip joint, which was reported by Postel and Kerboull. RDC is commonly unilateral and occurs mostly in elderly women. Immune thrombocytopenic purpura (ITP) is characterized by a low platelet count that is the result of both immune-mediated platelet destruction and suppression of platelet production. In patients with ITP undergoing surgery, bleeding associated with a low preoperative platelet count can lead to unsuccessful outcomes. To the best of our knowledge, there has been only one report describing total hip arthroplasty (THA) for patients with ITP and there have been no reports of THA for RDC with a very low platelet count due to liver cirrhosis (LC) and ITP. We report the case of a patient who had right RDC and a very low platelet count due to LC and ITP in whom THA was successfully performed. Furthermore, this case was also unique in that her platelet count increased after THA. THA for right RDC might resolve ITP by relieving inflammation of the right hip since her platelet count recovered after THA.

scholarly journals An Unusual Cause of Secondary ITP in a 34-Year-Old Hispanic Male

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ayrton Bangolo ◽  
Mohamed Ahmed ◽  
Ali Atoot ◽  
Ashraf Mahmoud ◽  
Chibuzo Agbakwuru-Onyike ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Platelet Count ◽  
Case Report ◽  
Geographic Distribution ◽  
Immune Thrombocytopenic Purpura ◽  
Severe Thrombocytopenia ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
H Pylori ◽  
Hispanic Male

Secondary immune thrombocytopenic purpura (ITP) associated with Helicobacter pylori (H. pylori) infection has been described in the literature. It appears to have a geographic distribution; mostly encountered in countries with a higher prevalence for H. pylori such as Italy or Japan. H. pylori eradication has been recommended in the management of ITP with studies showing improvement in the platelet count in some patients. Substantial platelet count increases in patients with severe thrombocytopenia (platelet counts <30 × 103 microliter), however, are uncommon with H. pylori treatment alone. Here, we present a 34-year-old Hispanic male with worsening chronic thrombocytopenia that resolved following eradication of his H. pylori infection. Herein, we highlight a rare and reversible cause of secondary ITP. With this case report, we hope to encourage physicians to include H. pylori testing in the evaluation of thrombocytopenia.

scholarly journals Management of Immune thrombocytopenic purpura during pregnancy: A single center experience

2018 ◽  
Vol 1 (3) ◽  
pp. 3-7
Author(s):  
B.S. Poudyal ◽  
T. Sampurna ◽  
S. Neupane ◽  
P.R. Shrestha ◽  
N. Chitrakar ◽  
...  
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Immune Thrombocytopenic Purpura ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Oral Prednisolone ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Single Center Experience ◽  
Low Platelet Count

Background: Immune thrombocytopenic Purpura (ITP) is the second most common cause of an isolated low platelet count during pregnancy. It account for about 3% of thrombocytopenic cases during delivery. Treatment is indicated, if there is an evidence of bleeding or platelet count is less than 30,000/µl. Herein, we presented a medical record of twenty-four pregnant women, who were diagnosed with ITP during pregnancy. Method: A total number of twenty four pregnant women diagnosed with primary ITP and having platelet count of less than 30000/µl were enrolled in the study. Oral prednisolone (1mg/kg) was started in all patients with an aim to keep the platelet count above 50000/µl during delivery. Steroid was continued for 21 consecutive days and were tapered (10 mg) every week, if platelet counts were above 30000/µl. Data pertaining to the ITP during pregnancy was recorded for age, platelet count, mode of delivery and complications related to steroid therapy and were analyzed by simple statistical analysis. Result: ITP was observed in about 58%, 25% and 17% of the cases during first, second and third trimester respectively. About, 63% of patients presented with purpuric rash, 18% presented with mucosal bleed, one present presented with hematuria and others were asymptomatic. More than two third of cases responded to the steroid and in those cases platelet counts were above 50,000/µl at the time of delivery. All subjects delivered a healthy child. There was no maternal mortality and post-partum hemorrhage was absent in all patients. Conclusion: Steroid is the treatment of choice for all cases of ITP. ITP is no longer a contraindication to the continuation of pregnancy, the tradition and tendency to advice for abortion in these pregnant mothers, may not be justifiable.

scholarly journals Immune Thrombocytopenic Purpura in a Child with COVID-19: A Case Report

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Marjan Tariverdi ◽  
Maliheh Mohammadzadeh Esini ◽  
Hanie Pazarkar ◽  
Zahra Naghmehsanj ◽  
Nazanin Farahbakhsh
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Healthcare Workers ◽  
Clinical Manifestations ◽  
Thrombocytopenic Purpura ◽  
Radiographic Findings ◽  
Case Presentation ◽  
Low Platelet Count ◽  
Viral Testing ◽  
Atypical Presentations

Introduction: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It may have many undescribed clinical manifestations. Case Presentation: In this study, we report a 7-year-old male COVID-19 patient with low platelet count who presented with gingival bleeding and ecchymosis and had a good response to corticosteroid therapy. Conclusions: This case highlights the need to be vigilant for atypical presentations or complications of COVID-19, one of which is SARS-CoV-2-induced immune thrombocytopenic purpura (ITP). It is necessary to pay attention to platelet count in addition to typical clinical features and radiographic findings. On the other hand, viral testing in thrombocytopenic patients should be considered for timely diagnosis of COVID-19 and taking necessary measurements for patient isolation in order to prevent the spread of disease and healthcare workers’ infection during this pandemic.

scholarly journals Cytomegalovirus: A possible cause of Persistent Refractory Immune Thrombocytopenic Purpura

2014 ◽  
Vol 3 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Raksha Shrestha ◽  
Damiano Rondelli ◽  
Mingma Thsering Sherpa
Keyword(s):  
Internal Medicine ◽  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Cytomegalovirus Infection ◽  
Severe Thrombocytopenia ◽  
Minor Trauma ◽  
Aggressive Treatment ◽  
Thrombocytopenic Purpura ◽  
A Minor ◽  
Possible Cause

We present a case of a healthy 22 years old who presented with bruising and hematoma following a minor trauma. Investigations showed severe thrombocytopenia but complete hematological investigations did not reveal a cause. An aggressive treatment with steroids, IVIG, anti-D, splenectomy and immunosuppressant proved to be refractory. A subclinical transaminitis prompted an infectious workup which revealed Cytomegalovirus infection. Platelet count improved and remained stable after eradication of Cytomegalovirus. We conclude that infection with CMV should be ruled out in cases of severe refractory immune thrombocytopenic purpura. DOI: http://dx.doi.org/10.3126/jaim.v3i1.10704   Journal of Advances in Internal Medicine 2014;03(01):42-45

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