Persistent, Poorly Responsive Immune Thrombocytopenia Secondary to Asymptomatic COVID-19 Infection in a Child

IF 1 Q4 INFECTIOUS DISEASES Case Reports in Infectious Diseases Pub Date : 2023-12-15 DOI:10.1155/2023/3298520
C. Mettananda, Senani Williams
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Abstract

Immune thrombocytopenic purpura (ITP) secondary to asymptomatic COVID-19 infection, especially in children, is not reported. Furthermore, persistent, treatment-resistant ITP secondary to COVID-19 is not reported. We report a previously healthy 14-year-old Asian boy who developed secondary ITP following an asymptomatic COVID-19 infection and is having a relapsing and remitting cause with poor response to immunosuppressants even after 21 months following the diagnosis. This case emphasizes the importance of testing for COVID-19 in newly diagnosed ITP patients and the need for follow-up platelet counts in patients who recover from COVID-19 as it may follow into developing secondary ITP yet being asymptomatic until you present with a bleeding complication of ITP. The poor response to standard immunosuppression warrants more understanding of the pathophysiology of persistently low platelets following COVID-19 infection. Long-term sequelae of the disease highlight the importance of getting vaccinated for COVID-19 despite COVID-19 being no longer a global emergency.
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一名儿童继发于无症状 COVID-19 感染的持续性、反应性差的免疫性血小板减少症
因无症状感染 COVID-19 而继发免疫性血小板减少性紫癜(ITP)的病例(尤其是儿童)尚未见报道。此外,继发于 COVID-19 的持续性、耐药性 ITP 也未见报道。我们报告了一名之前身体健康的 14 岁亚洲男孩,他在无症状感染 COVID-19 后继发了 ITP,即使在确诊后 21 个月仍出现复发和缓解,且对免疫抑制剂反应不佳。本病例强调了对新诊断的 ITP 患者进行 COVID-19 检测的重要性,以及对从 COVID-19 感染中康复的患者进行血小板计数随访的必要性,因为 COVID-19 感染可能会导致继发性 ITP,但患者在出现 ITP 出血并发症之前并无症状。由于对标准免疫抑制的反应不佳,因此需要进一步了解 COVID-19 感染后血小板持续偏低的病理生理学。尽管COVID-19已不再是全球紧急事件,但该疾病的长期后遗症凸显了接种COVID-19疫苗的重要性。
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审稿时长
13 weeks
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