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Case Reports
. 2020 Nov;112(5):746-750.
doi: 10.1007/s12185-020-02931-9. Epub 2020 Jul 1.

Severe immune thrombocytopenic purpura in critical COVID-19

Valérie Lévesque  1 , Émilie Millaire  1 , Daniel Corsilli  2 , Benjamin Rioux-Massé  3 , François-Martin Carrier  4   5   6   7
Affiliations
Case Reports

Severe immune thrombocytopenic purpura in critical COVID-19

Valérie Lévesque et al. Int J Hematol. 2020 Nov.

Abstract

COVID-19 is a new disease with many undescribed clinical manifestations. We report herein a case of severe immune thrombocytopenic purpura (ITP) in a critical COVID-19 patient. A patient presented a severe episode of immune thrombocytopenia (< 10 × 109/L) 20 days after admission for a critical COVID-19. This thrombocytopenia was associated with a life-threatening bleeding. Response to first-line therapies was delayed as it took up to 13 days after initiation of intravenous immunoglobulin and high-dose dexamethasone to observe an increase in platelet count. COVID-19 may be associated with late presenting severe ITP. Such ITP may also be relatively resistant to first-line agents. Hematological manifestations of COVID-19, such as the ones associated with life-threatening bleeding, must be recognized.

Keywords: Bleeding; COVID-19; Corticosteroids; Immunoglobulin; Thrombocytopenia.

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Conflict of interest statement

All authors declare they have no competing interests.

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