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

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.

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Shunpei Hama ◽  
Fumiaki Inori ◽  
Dai Momose ◽  
Sadahiko Konishi

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.


2021 ◽  
Vol 8 (2) ◽  
pp. 31-36
Author(s):  
Katherine Cooper ◽  
Bradley Switzer

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.


2012 ◽  
Vol 10 (1) ◽  
pp. 77-82 ◽  
Author(s):  
MR Sigdel ◽  
DS Shah ◽  
MP Kafle ◽  
KB Raut

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


2018 ◽  
Vol 1 (3) ◽  
pp. 3-7
Author(s):  
B.S. Poudyal ◽  
T. Sampurna ◽  
S. Neupane ◽  
P.R. Shrestha ◽  
N. Chitrakar ◽  
...  

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.


2015 ◽  
Vol 8 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Jiaxin Niu ◽  
Teresa Goldin ◽  
Maurie Markman ◽  
Madappa N. Kundranda

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.


Blood ◽  
1988 ◽  
Vol 71 (5) ◽  
pp. 1499-1502 ◽  
Author(s):  
E Oksenhendler ◽  
P Bierling ◽  
Y Brossard ◽  
C Schenmetzler ◽  
PM Girard ◽  
...  

Abstract The potential hazards of steroids in human immunodeficiency virus (HIV)- infected patients led us to evaluate the effectiveness and safety of anti-D and anti-c Ig in 17 adults with severe HIV-related immune thrombocytopenic purpura (platelet count less than 20 x 10(9)/L). The 14 Rh+ patients received 12 to 25 micrograms/kg of anti-D IgG intravenously on two consecutive days. A significant platelet rise above 50 x 10(9)/L was obtained in nine patients. Repeated boosters were performed in six cases and were effective in all cases. The 3 Rh- patients had a good response after they were given 20 mL x 2 of plasma containing potent anti-c antibodies. Therapy was well tolerated, and only one patient had significant hemolysis. These data suggest that anti-Rh IgG can be effective and safe in HIV-related thrombocytopenic purpura and that a specific interaction between the RBC antigens and the anti-Rh antibodies is required.


Blood ◽  
1981 ◽  
Vol 57 (4) ◽  
pp. 809-811 ◽  
Author(s):  
BS Morse ◽  
D Giuliani ◽  
M Nussbaum

Abstract Platelet-associated IgG (PAIgG) was measured by a simple radial immunodiffusion technique using washed solubilized platelets and commercially available immunoplates. Subjects with normal platelet counts had PAIgG levels of 1.5--7.0 fg/platelet. Subjects with idiopathic immune thrombocytopenic purpura (ITP) had levels ranging from 5.7 to 70.5 fg/platelet. All patients with recurrent ITP and 85% of patients with acute ITP had elevated PAIgg. Elevated PAIgG was also found in 17% of patients with recovered ITP, 40% of patients with SLE and thrombocytopenia, 57% of patients with thrombocytopenia occurring during the course of septicemia, and 100% of patients with IgG myeloma in whom the serum IgG level was clearly elevated, regardless of the platelet count. The results are similar to reports that used more complex techniques.


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