SHM Converge Scientific Abstract ePoster Gallery-Immune Thrombocytopenia Induced by Covid-19

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This case report describes a 28-year-old unvaccinated man with a past history of Hodgkin’s lymphoma in remission who developed profound thrombocytopenia after a likely COVID-19 infection. He had respiratory symptoms after exposure to COVID-19 about six weeks before admission, then later developed oral bleeding and petechiae. His platelet count fell to 1 x 10⁹/L, while the rest of his blood counts were normal. Bone marrow biopsy showed megakaryocytes and no lymphoma recurrence, supporting immune thrombocytopenia (ITP). Although his nasal PCR was negative, COVID-19 IgG was positive, suggesting prior infection and making COVID-19–induced ITP the presumed diagnosis.<br /><br />He was treated with dexamethasone, platelet transfusions, glucocorticoids, IVIG, rituximab, and eltrombopag. Platelet transfusions produced only transient small increases, consistent with ongoing platelet destruction. After about one month, he was discharged with platelets improved to 92 x 10⁹/L.<br /><br />The report highlights that COVID-19 can trigger ITP in adults and children, sometimes even without obvious symptoms. Because of this, COVID-19 testing should be considered in any new ITP diagnosis. Management generally follows standard ITP guidelines: high-dose steroids are first-line therapy, while second-line options include IVIG, rituximab, thrombopoietin receptor agonists such as eltrombopag or romiplostim, and splenectomy. Treatment is recommended for patients with platelet counts below 30 x 10⁹/L, significant bleeding, or important comorbidities; otherwise, observation may be appropriate.

Asset Subtitle

Alexandra M. Glaeser

Meta Tag

Author List Alexandra M. Glaeser

Category Clinical Vignettes

Concept Immune Thrombocytopenia

Concept COVID-19

Concept Adult ITP Treatment

Concept Corticosteroids

Concept Platelet Count Threshold

Distinguished Non-Finalist

Presenter Organization Univeristy of California Los Angeles, Department of Medicine

Presenting Author Alexandra M. Glaeser

Track Adult

Keywords

COVID-19

immune thrombocytopenia

ITP

thrombocytopenia

Hodgkin lymphoma

platelet transfusion

dexamethasone

IVIG

rituximab

eltrombopag

Immune Thrombocytopenia

COVID-19

Adult ITP Treatment

Corticosteroids

Platelet Count Threshold