American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2021, 9(3), 147-149
DOI: 10.12691/ajmcr-9-3-3
Open AccessCase Report

A Rare Presentation of COVID-19 Associated Thrombotic Thrombocytopenic Purpura; Therapeutic Challenges

Eman EL-Sawalhy1, , Hammam Shereef2, Hana Manzoor2, Fadi Abuhmaid3 and Shahina Patel4

1Department of Internal Medicine, Beaumont Hospital, Dearborn, MI

2Department of Internal Medicine, Beaumont Health-Dearborn, 18101 Oakwood Blvd. Dearborn, MI

3Division of Nephrology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI

4Division of Hematology & Oncology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI

Pub. Date: December 30, 2020

Cite this paper:
Eman EL-Sawalhy, Hammam Shereef, Hana Manzoor, Fadi Abuhmaid and Shahina Patel. A Rare Presentation of COVID-19 Associated Thrombotic Thrombocytopenic Purpura; Therapeutic Challenges. American Journal of Medical Case Reports. 2021; 9(3):147-149. doi: 10.12691/ajmcr-9-3-3


Since COVID-19 has been declared a global pandemic, variable clinical presentations have been reported, most commonly with respiratory symptoms and less commonly gastrointestinal or neurological symptoms. Hematologic disorders in the form of thrombotic microangiopathies (TMA) such as immune thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and microangiopathic hemolytic anemia (MAHA) were also linked to the COVID-19 positive population. Many studies have proposed several possible theories, including viral-mediated, endothelial related, immune triggered, and consumptive mechanisms. In most of the literature, the severity of the disease is associated with more severe thrombocytopenia, with lower levels being associated with higher mortality. We herein report a case of a patient who tested positive for COVID-19 and went on to develop severe thrombocytopenia. Workup of the thrombocytopenia revealed that he had developed acquired Thrombotic thrombocytopenic purpura (TTP). Our case report highlights the need for early recognition, prompt diagnosis, and the subsequent initiation of urgent treatment.


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