SARS-COV-2 infection in a patient with Evans syndrome: a silent enemy or an ally?

Nikola M Pantić; Mirjana Mitrović; Marijana Virijević; Nikica Sabljić; Zlatko Pravdić; Nada Suvajdžić

doi:10.2298/VSP200811115P

Nikola M Pantić Clinic of Hematology, Clinical Center of Serbia https://orcid.org/0000-0001-7798-4026
Mirjana Mitrović Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia
Marijana Virijević Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia
Nikica Sabljić Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia
Zlatko Pravdić Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia
Nada Suvajdžić Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP200811115P

Keywords: covid-19;, evans syndrome;, purpura, thrombocytopenic, idiopathic;, romiplostim;, thrombocytosis

Abstract

Introduction. During the current outbreak of Coronavirus disease 2019 (COVID-19), the way to manage patients with autoimmune diseases remains elusive due to limited data available. Case report. We presented a case of a COVID-19 positive 20-year-old female with prior history of Evans syndrome. The patients remained asymptomatic even though she had been treated with immunosuppressants (prednisolone and azathioprine) together with romiplostim. Moreover, her course of infection was accompanied by thrombocytosis, although her platelet count was mostly below the reference range before the infection. The patient was monitored vigilantly, with special regard to platelet count and signs of thrombotic events. Conclusion. Platelet count monitoring and romiplostim administration should be performed more cautiously in chronic immune thrombocytopenic patients infected by SARS-CoV-2.

Author Biographies

Mirjana Mitrović, Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia

Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia;

University of Belgrade, Faculty of Medicine, Belgrade, Serbia

Marijana Virijević, Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia

Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia;

University of Belgrade, Faculty of Medicine, Belgrade, Serbia

Nada Suvajdžić, Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia

Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia;

University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Full professor, Department of Internal Medicine

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