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New disease
Case report
Severe thrombocytopaenia secondary to COVID-19
  1. Trupesh Patel1,
  2. Noah Stanton1,
  3. Ioannis Gkikas2 and
  4. Diana Ioanna Dionysia Triantafyllopoulou3
  1. 1Department of Medicine, Royal Blackburn Teaching Hospital, Blackburn, Lancashire, UK
  2. 2Gastroenterology, Royal Blackburn Teaching Hospital, Blackburn, Lancashire, UK
  3. 3Haematology, Royal Blackburn Teaching Hospital, Blackburn, Lancashire, UK
  1. Correspondence to Dr Diana Ioanna Dionysia Triantafyllopoulou; diana.triantafyllopoulou{at}elht.nhs.uk

Abstract

The SARS-CoV-2 infection has caused a pandemic with a case rate of over 290 000 lab-confirmed cases and over 40 000 deaths in the UK. There is little evidence to inform the optimal management of a patient presenting with new or relapsed acute idiopathic thrombocytopaenic purpura with concurrent SARS-CoV-2 infection. We present a case of severe thrombocytopaenia complicated by subdural haematoma and rectal bleed associated with COVID-19. A 67-year-old man, admitted with a non-productive cough and confusion, was found to be positive for COVID-19. Ten days after admission, his platelets decreased from 146×109/L to 2×109/L. His platelets did not increase despite receiving frequent platelet transfusions. He was non-responsive to corticosteroids and intravenous immunoglobulins. Romiplostim and eltrombopag were given and after 9 weeks of treatment, his platelet count normalised. He was deemed medically fit with outpatient follow-up in a haematology clinic.

  • infections
  • pneumonia (infectious disease)
  • malignant and benign haematology

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-237645

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    Footnotes

    • TP and NS are joint first authors.

    • Contributors TP, NS, IG and DIDT are the authors of the case report and have contributed equally. IG contributed to the conceptualisation and editing. DIDT contributed in the editing of the case report and in the discussion.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.