Covid-19 Enfeksiyonu Sonrası İmmün Trombositopeni Tanısı Alan Hastaların Retrospektif Analizi ve Literatür Özeti

Year 2022, Volume: 44 Issue: 6, 881 - 886, 28.11.2022

Fatih Yaman , Neslihan Andıc , Nur Oguz Davutoglu , Hava Üsküdar Teke , Eren Gunduz

https://doi.org/10.20515/otd.1128627

Abstract

İmmün trombositopenik purpura (ITP) olarak bilinen immün trombositopeni, COVID-19'un önemli bir komplikasyonu olarak ortaya çıkabilmektedir. COVID-19 ile ilişkili ITP'yi teşhis etmek için kapsamlı bir yaklaşım gereklidir. Bu çalışmada COVID-19 PCR pozitifliği sonrası ilk 60 gün içinde ITP tanısı alan 7 hasta sunulmuştur. Hastaların tanıdaki medyan trombosit sayısı 16x109/L’dir. Şiddetli hayatı tehdit eden kanama yoktu. COVID-19 semptomlarının başlangıcından ITP tanısına kadar geçen medyan gün sayısı 21 gün olarak bulundu. Kemik iliği baskılanması, mikrovasküler trombüs nedeniyle trombosit tüketimi veya trombositlerin otoimmün yıkımı gibi çeşitli mekanizmalar COVID-19 ilişkili trombositopeni nedeni olabilir. IVIG tedavisine yanıt alınmıştır ancak IVIG sonrası medyan 13 günde relaps gelişmiştir. Relaps olan hastalarda kortikosteroid kullanılabilir. COVID-19 sonrası hastalarda trombositopeni gelişimi açsından dikkatli olunmalıdır. Yeni tanı ITP’li hastalarda COVID-19 testi yapılmalıdır.

Keywords

COVİD-19, immun trombositopeni, tedavi

Retrospective Analysis of Patients Diagnosed with Immune Thrombocytopenia After Covid-19 Infection and Review of the Literature

Abstract

Immune thrombocytopenia, known as immune thrombocytopenic purpura (ITP), has emerged as a major complication of COVID-19. A comprehensive approach is required to diagnose ITP associated with COVID-19. In this study, 7 patients who were diagnosed with ITP in the first 60 days after COVID-19 PCR positivity were presented. The median platelet count of the patients at diagnosis is 16x109/L. There was no severe life-threatening bleeding. The median day from the onset of COVID-19 symptoms to the diagnosis of ITP was 21 days. Various mechanisms such as bone marrow suppression, platelet consumption due to microvascular thrombus, or autoimmune destruction of platelets may be the cause of COVID-19-associated thrombocytopenia. Response to IVIG treatment was achieved, but relapse developed in a median of 13 days after IVIG. Corticosteroids can be used in patients with relapse. Care should be taken in terms of the development of thrombocytopenia in patients after COVID-19. Patients with newly diagnosed ITP should be tested for COVID-19.

Keywords

COVİD-19, immune thrombocytopenia, treatment

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