Khot Rajashree, Kumbhalkar Sunita D, Juneja Richa, Joshi Prashant P
Department of General Medicine, AIIMS, Nagpur, Maharashtra, India.
Department of Pathology (Haematology), AIIMS, Nagpur, Maharashtra, India.
Eur J Case Rep Intern Med. 2021 Sep 13;8(9):002782. doi: 10.12890/2021_002782. eCollection 2021.
COVID-19 can have an unpredictable and severe course, leading to many hypotheses regarding its pathophysiology and clinical manifestations. Haematological manifestations are a significant predictor of disease severity. The most common observation is lymphopenia with an increased neutrophil:lymphocyte ratio. Platelets have been implicated in thrombogenic events, but the most frequently reported abnormality is mild thrombocytopenia. Here we present an interesting case of a patient with moderate COVID-19 who presented with cutaneous ecchymoses and thrombocytosis, and discuss this paradox.
Bleeding manifestations such as ecchymoses can occur as an idiosyncratic reaction to the administration of convalescent plasma therapy in COVID-19.Thrombocytosis can occur in COVID-19 and could be a contributory factor to disease vasculopathy.
新型冠状病毒肺炎（COVID-19）的病程可能不可预测且严重，引发了许多关于其病理生理学和临床表现的假说。血液学表现是疾病严重程度的重要预测指标。最常见的观察结果是淋巴细胞减少，中性粒细胞与淋巴细胞比值增加。血小板与血栓形成事件有关，但最常报告的异常是轻度血小板减少。在此，我们报告一例中度COVID-19患者出现皮肤瘀斑和血小板增多的有趣病例，并讨论这一矛盾现象。
瘀斑等出血表现可能是COVID-19患者接受恢复期血浆治疗后的特异反应。COVID-19可出现血小板增多，可能是疾病血管病变的一个促成因素。
