Thrombotic Thrombocytopenic Purpura (TTP) – a Rare Presentation with COVID-19

¹ Department of General Medicine, Aster MIMS Hospital, Kozhikode, Kerala, India

² Department of Nephrology, Aster MIMS Hospital, Kozhikode, Kerala, India

Corresponding author:

Dr. Jabir M P, Consultant, Department of General Medicine, Aster MIMS, Kozhikode-673016

Email: jabir.mp@asterhospital.com Phone: +91 94963 57213

Keywords:

COVID-19, Thrombotic thrombocytopenic purpura, plasma exchange, ADAMTS13

ABSTRACT

A 22-year-old female with no previous morbidities presented with acute onset neurological symptoms in the form of hemi-sensory phenomena. On evaluation, she had fever. Routine COVID-19 RT-PCR testing proved to be positive. During the course of hospital stay, the patient developed classical features of acquired TTP. Her ADAMTS13 level was 36% of normal activity, which is suggestive of direct, viral-mediated thrombotic microangiopathy. High VWF levels and low ADAMTS13 activity have both previously been reported with SARS-Cov-2 infection. In rare cases like ours, this can mimic classical TTP.

ABBREVIATIONS

TTP – Thrombotic thrombocytopenic purpura; COVID-19 – Coronavirus disease 2019;