key: cord-279525-76iq0gcy
authors: Kewan, Tariq; Almhana, Farah; Schwartzman, Larisa; Daw, Hamed; Haddad, Abdo
title: COVID‐19 patient with immune thrombocytopenic purpura
date: 2020-08-12
journal: Int J Lab Hematol
DOI: 10.1111/ijlh.13303
sha: 
doc_id: 279525
cord_uid: 76iq0gcy

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Immune thrombocytopenic purpura (ITP) is an acquired disease characterized by thrombocytopenia secondary to autoantibodies against platelet antigens. Secondary ITP is common after viral infections 1 . We here report a case of ITP in a patient with COVID-19

pneumonia.

An 89-year-old man with congestive heart failure, essential hypertension, type 2 diabetes, chronic kidney disease, and atrial fibrillation on anticoagulation (AC) presented to the emergency department in March 2020 with a 3-day history of shortness of breath, dry cough, and diarrhea. On admission, he was stable and required 2 L oxygen to keep his oxygen saturation 90%. Physical examination was remarkable for bibasilar crackles.

Laboratory tests on admission showed a normal white cell count, hemoglobin (Hb) of 12.0 g/d, and platelet count (175 000/mm 3 ).

C-reactive protein (CRP) and D-dimer were elevated at 10.9 mg/dL and 970 ng/mL. A nasopharyngeal swab was positive for COVID-19.

Chest X-ray showed bilateral lung infiltrates.

The patient was admitted to the regular medical floor and started on hydroxychloroquine, intravenous piperacillin/tazobactam, and azithromycin. On day 13, the patient's oxygen requirements increased and he was transferred to the intensive care unit (ICU) for monitoring. On the same time, his platelet count dropped acutely to less than 2,000/mm 3 (Figure 1 ). At the same day, his Hb was 10. 

The authors declare that they have no conflict of interest.

TK, FA, LS, HD, and AD contributed to the conception and design of study. TK, FA, and AD interpreted the data. TK wrote the first draft of the report. All authors contributed to article revision and approved the submitted version. 

Immune thrombocytopenic purpura

A Novel coronavirus from patients with pneumonia in China

Immune thrombocytopenic purpura in a patient with Covid-19

COVID-19-associated immune thrombocytopenia

Hemostatic laboratory derangements in COVID-19 with a focus on platelet count

Updated international consensus report on the investigation and management of primary immune thrombocytopenia

Practical guidance for the management of adults with Immune Thrombocytopenia during the COVID-19 pandemic