Sadr Sara, SeyedAlinaghi SeyedAhmad, Ghiasvand Fereshteh, Hassan Nezhad Malihe, Javadian Nina, Hossienzade Roghieh, Jafari Fatemeh
Mazandaran University of Medical Sciences, School of Medicine, Sari, Iran.
Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
IDCases. 2020 May 29;21:e00820. doi: 10.1016/j.idcr.2020.e00820. eCollection 2020.
COVID-19 is known to cause serious respiratory symptoms and involvement of other body systems such as hematopoietic, neurological and the immune system. In this report, we described a case of a COVID-19 patient who presented with no pulmonary involvement but severe thrombocytopenia. She suffered from headache and malaise with no respiratory symptoms, fever or chills. Chest radiological imaging was unremarkable but, the laboratory results showed significant thrombocytopenia associated with relatively decreased lymphocytes. Based on her high-risk work environment, a reverse transcription polymerase chain reaction (RT-PCR) test was performed and SARS-CoV-2 RNA was detected in the nasopharyngeal swab. Complete blood count (CBC) of patient was re-checked during admission and platelet count showed rising trend up to normal levels. A narrow diagnostic approach where only febrile patients with pulmonary symptoms are evaluated for a COVID-19 diagnosis will result in many missed diagnoses; so it is important that physicians are familiar with atypical and rare presentations of COVID-19, such as isolated thrombocytopenia.
已知新型冠状病毒肺炎（COVID-19）会引发严重的呼吸道症状，并累及其他身体系统，如造血系统、神经系统和免疫系统。在本报告中，我们描述了一例COVID-19患者，该患者没有肺部受累，但出现了严重的血小板减少症。她有头痛和不适症状，无呼吸道症状、发热或寒战。胸部放射影像学检查无异常，但实验室结果显示存在明显的血小板减少症，同时淋巴细胞相对减少。基于她的高风险工作环境，进行了逆转录聚合酶链反应（RT-PCR）检测，在鼻咽拭子中检测到了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RNA。患者入院期间复查了全血细胞计数（CBC），血小板计数呈上升趋势，直至恢复正常水平。仅对有肺部症状的发热患者进行COVID-19诊断的狭义诊断方法会导致许多漏诊；因此，医生熟悉COVID-19的非典型和罕见表现，如孤立性血小板减少症，非常重要。
