SHM Converge Scientific Abstract ePoster Gallery-What's Covid Got to Do With It(p): Covid-19 Induced Idiopathic Thrombocytopenic Purpura in a 20 Year Old

Pdf Summary

This case report describes a previously healthy young woman who presented with severe bleeding symptoms, including melena, hematemesis, vaginal bleeding, gum bleeding, and widespread petechiae. She also had recent COVID-19 symptoms such as cough, fever, and anosmia, and testing confirmed SARS-CoV-2 infection. Her labs showed profound thrombocytopenia with a platelet count of 4 × 10^9/L, while coagulation studies and peripheral smear did not suggest disseminated intravascular coagulation or thrombotic microangiopathy.<br /><br />She was diagnosed with immune thrombocytopenia (ITP) triggered by acute COVID-19 infection. Initial treatment included intravenous immunoglobulin (IVIg) for two days and high-dose dexamethasone for four days. Because she continued to have severe thrombocytopenia and mucosal bleeding after a week, she was given romiplostim, a thrombopoietin receptor agonist. Her bleeding improved, platelet count stabilized in the 25–30 × 10^9/L range, and she was discharged. After an additional outpatient dose of romiplostim, her platelet count rose to 604 × 10^9/L by day 14, with no further bleeding.<br /><br />The discussion notes that ITP is a known autoimmune complication of several viral infections, and although COVID-19 is more commonly associated with thrombosis, it can also cause severe bleeding through ITP. Reported cases have mostly involved older adults, making this young, otherwise healthy patient notable. The authors emphasize that glucocorticoids and IVIg often work well, while thrombopoietin receptor agonists may be needed in refractory cases. Clinicians should remain alert to both thrombotic and bleeding complications of COVID-19 to ensure timely diagnosis and treatment.

Asset Subtitle

Ashmita Chatterjee

Meta Tag

Author List Ashmita Chatterjee, John R. Stephens, Nicholas Piazza, Patrick M. O'Shea, Robert A. Campbell

Category Clinical Vignettes

Concept COVID-19

Concept Immune Thrombocytopenia

Concept Thrombocytopenia

Concept Corticosteroids

Concept Intravenous Immunoglobulin

Distinguished Non-Finalist

Presenter Organization Unc

Presenting Author Ashmita Chatterjee

Track Adult

Keywords

immune thrombocytopenia

COVID-19

SARS-CoV-2 infection

thrombocytopenia

romiplostim

intravenous immunoglobulin

dexamethasone

mucosal bleeding

petechiae

platelet count

COVID-19

Immune Thrombocytopenia

Thrombocytopenia

Corticosteroids

Intravenous Immunoglobulin