Department of Medicine, Norwalk Hospital, 382886Western Connecticut Health Network, Norwalk, USA.
Department of Hematology and Oncology, Danbury Hospital, 382886Western Connecticut Health Network, Norwalk, USA.
Lupus. 2020 Oct;29(11):1472-1474. doi: 10.1177/0961203320940389. Epub 2020 Jul 8.
The coronavirus disease 2019 (COVID-19) pandemic has created new challenges that necessitate prompt responses in unexpected clinical situations. Multiple extrapulmonary manifestations and complications of COVID-19 have already been described, but only scattered data are present on immunologic manifestations. We present a case of severe refractory thrombocytopenia in a 51-year-old woman with a history of long-standing systemic lupus erythematosus and antiphospholipid syndrome who presented with hemoptysis in the setting of COVID-19 infection. The patient failed to respond to initial treatment with intravenous immunoglobulin, high-dose steroids, and platelet transfusion, but responded to eltrombopag, with prompt improvement of a platelet count. The current case report provides clinical data of relevance to the largely unexplored question of the immunologic complications of COVID-19 in patients with a pre-existing inflammatory state.
2019 年冠状病毒病（COVID-19）大流行带来了新的挑战，需要在意外的临床情况下迅速做出反应。已经描述了 COVID-19 的多种肺外表现和并发症，但关于免疫表现只有零星的数据。我们报告了一例 51 岁女性的严重难治性血小板减少症病例，该患者有长期的系统性红斑狼疮和抗磷脂综合征病史，在 COVID-19 感染的背景下出现咯血。该患者对初始静脉注射免疫球蛋白、大剂量类固醇和血小板输注治疗无反应，但对艾曲波帕有反应，血小板计数迅速改善。本病例报告提供了与 COVID-19 患者在存在炎症状态下的免疫并发症这一大部分尚未探索的问题相关的临床数据。
