Department of Hematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Int Immunopharmacol. 2021 Apr;93:107397. doi: 10.1016/j.intimp.2021.107397. Epub 2021 Jan 22.
Thrombotic microangiopathies are a group of disorders that are mainly related to endothelial dysfunction. This category of endothelial dysfunction results of several imbalances between platelets, endothelium and immune system, also cytokine production.
To report cases with thrombotic thrombocytopenic purpura (TTP) and COVID-19 and review COVID-19 endothelial dysfunction literature.
Primary laboratory data, peripheral blood smear, ADAMTS13 antigen activity level, and antibody ordered for each of these four patients. Treatments for COVID-19 administered for all patients. Traditional treatments for TTP also were administered.
There were numerous schistocytes (more than 5%) in peripheral blood smears for each patient. ADAMTS13 antigen activity level was below 10%, and ADAMTS13 antibody was elevated for each patient. COVID-19 PCR was positive for all patients, and CT-Scans were indicative of the involvement of COVID-19.
In this case series, we reported four COVID-19 patients who presented with signs and symptoms of anemia and thrombocytopenia, resulting in thrombotic thrombocytopenic purpura.
血栓性微血管病是一组主要与内皮功能障碍有关的疾病。这一类内皮功能障碍是由血小板、内皮和免疫系统之间的几种失衡以及细胞因子的产生引起的。
报告血栓性血小板减少性紫癜（TTP）和 COVID-19 病例，并回顾 COVID-19 内皮功能障碍的文献。
对这四位患者的外周血涂片、ADAMTS13 抗原活性水平和抗体进行了初步的实验室检查。对所有患者进行了 COVID-19 的治疗。也对 TTP 的传统治疗进行了治疗。
每位患者的外周血涂片上都有大量的裂体细胞（超过 5%）。ADAMTS13 抗原活性水平低于 10%，每位患者的 ADAMTS13 抗体均升高。所有患者的 COVID-19 PCR 均为阳性，CT 扫描显示 COVID-19 受累。
在本病例系列中，我们报告了四名 COVID-19 患者，他们出现了贫血和血小板减少的症状和体征，导致血栓性血小板减少性紫癜。
