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儿童急性淋巴细胞白血病继发于 SARS-CoV-2 感染的免疫性血小板减少性紫癜:病例报告及文献复习。

Immune thrombocytopenic purpura secondary to SARS-CoV-2 infection in a child with acute lymphoblastic leukaemia: a case report and review of literature.

机构信息

Department of Medical Oncology, Alexis Multispeciality Hospital, Nagpur, Maharashtra, India.

Department of Paediatrics, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India

出版信息

BMJ Case Rep. 2021 Nov 5;14(11):e245869. doi: 10.1136/bcr-2021-245869.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/842a/8573630/d67949686a1e/bcr-2021-245869f01.jpg

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