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Autoimmune Thrombocytopenia in SLE and COVID-19
Yeremia Suryo Pratama1, Riska Pradiptakirana1, Azkia Rachmah1
1Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia.
Insights
In patients with both COVID-19 and systemic lupus erythematosus (SLE), thrombocytopenia may stem from lupus relapse rather than infection. Glucocorticoids effectively treated the low platelet count in this case.
Area of Science:
- Hematology
- Immunology
- Infectious Diseases
Background:
- Thrombocytopenia and hypercoagulopathy are common in COVID-19 and SLE.
- Concurrent presentation of COVID-19 and SLE poses diagnostic and therapeutic challenges.
- Understanding the underlying pathophysiology is crucial for effective management.
Purpose of the Study:
- To present a case of a patient with concurrent COVID-19 and SLE experiencing thrombocytopenia.
- To analyze the potential causes of thrombocytopenia in this complex clinical scenario.
- To evaluate the efficacy of glucocorticoid therapy.
Main Methods:
- Case report of a 20-year-old female with a history of SLE and COVID-19 infection.
- Clinical assessment including platelet count and D-dimer levels.
- Therapeutic intervention with glucocorticoids.
Main Results:
- The patient presented with thrombocytopenia but normal D-dimer levels.
- Thrombocytopenia was attributed to a lupus relapse rather than COVID-19.
- Glucocorticoid therapy resulted in excellent recovery of platelet count.
Conclusions:
- Thrombocytopenia in concurrent COVID-19 and SLE is not always due to platelet consumption.
- Low-dose glucocorticoids are a potential treatment, considering infection risks and comorbidities.
- Glucocorticoid use may potentially delay viral clearance.
Abstract:
Thrombocytopenia and hypercoagulopathy are haematological abnormalities commonly seen in individuals with coronavirus disease 2019 (COVID-19) and systemic lupus erythematosus (SLE). The difficulty arises when the patient has both diseases concurrently. The clinician should be able to comprehend the pathophysiology of these patient abnormalities in order to provide the best treatment possible. We present a case of a 20-year-old female COVID-19 patient with a history of SLE who had thrombocytopenia but normal D-dimer results. Our analysis revealed that the thrombocytopenia may have been caused by a relapse of lupus, not by COVID-19 infection. In this case, glucocorticoids were the primary therapy and produced excellent results.
Learning Points:
The pathophysiology of thrombocytopenia in a patient with concurrent COVID-19 and SLE should not always be associated with platelet consumption.Low-dose glucocorticoids should be administered, with infection risk and comorbidities taken into consideration.Glucocorticoid therapy may result in a delay in viral clearance.
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