Department of Medical Oncology, Alexis Multispeciality Hospital, Nagpur, Maharashtra, India.
Department of Paediatrics, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
BMJ Case Rep. 2021 Nov 5;14(11):e245869. doi: 10.1136/bcr-2021-245869.
Immune thrombocytopenic purpura (ITP) is characterised by isolated thrombocytopenia which may be idiopathic or due to a secondary aetiology. ITP is being increasingly recognised secondary to SARS-CoV-2 infection in the current pandemic. Here, we report a case of a five-and-a-half-year-old female child on maintenance chemotherapy for acute lymphoblastic leukaemia who subsequently developed ITP secondary to SARS-CoV-2 infection. Our patient had prolonged thrombocytopenia secondary to ITP, requiring the use of second-line agents including romiplostim and eltrombopag. This is a unique case where ITP was recognised secondary to SARS-CoV-2. In such cases of thrombocytopenia, ITP should be considered as an important differential in addition to relapse of leukaemia or thrombocytopenia due to chemotherapy drugs.
免疫性血小板减少性紫癜（ITP）的特征是孤立性血小板减少症，可能是特发性的，也可能是继发于某种病因。在当前的大流行中，人们越来越认识到 ITP 是继发于 SARS-CoV-2 感染。在这里，我们报告了一例五岁半的女性儿童，她正在接受急性淋巴细胞白血病的维持化疗，随后继发于 SARS-CoV-2 感染而发生 ITP。我们的患者因 ITP 导致血小板减少症持续时间延长，需要使用二线药物，包括罗米司亭和艾曲泊帕。这是一例继发于 SARS-CoV-2 的 ITP 的独特病例。在这种血小板减少症的情况下，除了白血病复发或化疗药物引起的血小板减少症外，还应考虑 ITP 作为重要的鉴别诊断。
