Department of Emergency Medicine, IRCCS San Matteo Hospital Foundation University of Pavia, Pavia, Italy.
Eur Rev Med Pharmacol Sci. 2020 Oct;24(20):10850-10852. doi: 10.26355/eurrev_202010_23447.
Patients with Covid-19 can have different symptoms, ranging from asymptomatic patients to various grades of respiratory failure, caused by typical interstitial pneumonia, cardiac involvement or neurological symptoms.
In April 2020, we focused our attention on a young woman with diffused purpura on her lower extremities, with no respiratory, cardiac or neurological symptoms. A complete blood analysis showed us a severe thrombocytopenia. We excluded other possible causes of thrombocytopenic purpura such as hematological (lymphocyte subsets), hepatological disease or splenomegaly. On autoimmune screening, we found Isolated immune thrombocytopenic purpura in a young adult Covid-19 patient positivity of anti-nuclear antibody (ANA) with a centrosome pattern and extractable nuclear antigens (ENA) and connective tissue disease screen resulted positive but none of the included specific antigens results positive, probably due to an aspecific antibody reaction. The wide variability of COVID disease presentation may be due to a personal different immune response to the virus.
The immune response against the virus is crucial in the evolution and understanding of COVID-19 disease but it has still to be fully understood.
新冠病毒患者的症状各不相同，从无症状患者到各种程度的呼吸衰竭，其病因包括典型间质性肺炎、心脏受累或神经系统症状。
2020 年 4 月，我们关注了一位年轻女性，她下肢出现弥漫性紫癜，无呼吸、心脏或神经系统症状。全血细胞分析显示严重血小板减少。我们排除了其他可能导致血小板减少性紫癜的原因，如血液疾病（淋巴细胞亚群）、肝病或脾肿大。自身免疫筛查显示抗核抗体（ANA）阳性，呈中心体模式，可提取核抗原（ENA）和结缔组织疾病筛查阳性，但未发现任何特定抗原阳性，可能是由于非特异性抗体反应。COVID 疾病表现的广泛可变性可能是由于个人对病毒的不同免疫反应。
针对病毒的免疫反应对于 COVID-19 疾病的发展和理解至关重要，但仍有待充分了解。
