Secondary Immune Thrombocytopenia Associated With Asymptomatic COVID-19 Successfully Managed With Intravenous Immunoglobulin and Glucocorticoids

Abstract

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by low platelet counts of <100 × 10 9 /L with the absence of other blood count abnormalities. Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 which is manifested by a severe multisystemic disease. We present the case of a 76-year-old female who presented with ITP associated with COVID-19 and successfully managed with intravenous immunoglobulin and glucocorticoids.

COVID-19 associated with immune thrombocytopenia: a systematic review and meta-analysis

“…This study included a total of 7 case reports, two of them were reported from the United States [ 17 , 18 ], one from Canada [ 19 ], one from Italy [ 20 ], one from Turkey [ 21 ], and one from Greece [ 22 ]. The lowest platelet count ranged from 1 × 10 9 /L in Clerici et al [ 20 ] to 23 × 10 9 /L in Lévesque et al [ 19 ].…”

“…Ayesh et al reported a case of a 76-year-old female patient who presented with a 5-day history of skin rash, fatigue, mouth pain, visual disturbances, and arthralgia and a preexisting medical history of insulin-dependent T2DM essential hypertension, cerebrovascular accident, and hyperlipidemia. The patient recovered after being diagnosed with secondary ITP associated with COVID-19 [ 18 ].…”

“…During the hospitalization, the platelet count recovered sufficiently. Ayesh et al, 2021 [ 18 ] NA After 2 days of IVIG and five days of dexamethasone Following initial stabilization, she had two units of platelet transfusions, as well as aspirin and clopidogrel. After consulting with hematology, they decided to start her on weight-based IVIG and dexamethasone burst treatment.…”

Immune thrombocytopaenic purpura following COVID-19 infection masquerading as senile purpura

“…However, non-specific senile purpura is common in older adults, and pathological purpura, including ITP, can be easily misdiagnosed or overlooked in this population 5. The patient was treated with glucocorticoids and intravenous immunoglobulin, as described in the literature 1 6. The patient responded well to the treatment.…”