Department of Nephrology, Hospital Universitario de Getafe, Carr. Madrid-Toledo, Km 12,500, Getafe, 28905, Madrid, Spain.
Primary Care Center El Greco, Getafe, Madrid, Spain.
CEN Case Rep. 2021 May;10(2):250-254. doi: 10.1007/s13730-020-00553-y. Epub 2020 Nov 17.
Patients on dialysis may have an elevated risk of severe coronavirus disease 2019 (COVID-19) and its complications due to their high prevalence of comorbidities. Here we describe the case of an 80-year-old male undergoing peritoneal dialysis with a moderate SARS-CoV-2 infection who developed a purpuric dermatitis and ischemic stroke after successful recovery from his bilateral pneumonia. Erythemato-papular lesions affecting trunk and lower limbs appeared 17 days after the onset of SARS-CoV-2 symptoms. These kind of lesions are an infrequent cutaneous manifestation of COVID-19. The pathology revealed a moderate purpuric dermatitis affecting superficial dermis and corticoesteroids were prescribed achieving complete resolution. Arterial thrombosis affecting cerebellar vermis emerged 30 days after the onset of COVID-19 symptoms. It occurred 5 days after withdrawal of antithrombotic prophylaxis that the patient received from his admission until 2 weeks after discharge. He completely recovered from his paresis and continued on his regular antiaggregation therapy. This is the first case report published of a patient with PD with such COVID-19-related complications. More experience is needed to determine the appropriate length of antithrombotic prophylaxis especially in high-risk individuals.
透析患者由于其高发的合并症，可能具有罹患严重 2019 年冠状病毒病（COVID-19）及其并发症的高风险。在这里，我们描述了一位 80 岁男性的病例，他在患有中度 SARS-CoV-2 感染的情况下接受了腹膜透析，在成功治愈双侧肺炎后出现紫癜性皮炎和缺血性中风。在 SARS-CoV-2 症状出现后 17 天，出现累及躯干和下肢的红斑-丘疹性病变。这些病变是 COVID-19 的一种罕见皮肤表现。病理学显示影响真皮浅层的中度紫癜性皮炎，皮质类固醇被开处以达到完全缓解。在 COVID-19 症状出现后 30 天，出现影响小脑蚓部的动脉血栓形成。它发生在患者从入院到出院后 2 周内接受的抗血栓预防措施停药后 5 天。他的麻痹完全恢复，并继续接受常规抗聚集治疗。这是首例腹膜透析患者发生此类 COVID-19 相关并发症的病例报告。需要更多经验来确定抗血栓预防措施的适当时间长度，特别是在高危人群中。
