Alonso-Beato, RubenMorales-Ortega, AlejandroFernandez, Francisco Javier De la HeraMoron, Ana Isabel ParejoRios-Fernandez, RaquelRubio, Jose Luis CallejasCenteno, Norberto Ortego2023-02-092023-02-092021-05-10Alonso-Beato R, Morales-Ortega A, Fernández FJH, Morón AIP, Ríos-Fernández R, et al. Immune thrombocytopenia and COVID-19: Case report and review of literature. Lupus. 2021 Aug;30(9):1515-1521.http://hdl.handle.net/10668/17851Immune thrombocytopenia, also known as immune thrombocytopenic purpura (ITP), has been reported as an important complication related to COVID-19.We present a 49-year-old male patient with systemic lupus erythematosus with lupus nephritis, antiphospholipid syndrome and history of ITP who developed an ITP flare in the context of COVID-19. He had no bleeding manifestations and had a good response to prednisone treatment.We review the characteristics of the cases reported to date in the literature, with an analysis of 57 patients. Mean age was 56 years (±19.6 SD), and 50.9% were male. This was the first episode of ITP in most of the patients (86.05%), with SARS-CoV-2 acting as the initial trigger. We found that ITP flares may appear in both mild and severe COVID-19 cases. They also appeared at any time during the course of the disease, 48.2% of patients developed it during hospitalization, while it was diagnosed at admission in the rest of the cases. Platelet counts were significantly lower than other ITP series, with a median nadir platelet count of 8 × 109/L (IQR 2-17.75 × 109/L). These patients show a higher bleeding rate (61.4%) compared with other ITP series. They also show a better response to treatment, with good response to the first line therapies in 76.9% of them. The most common first-line treatment was intravenous immunoglobulin (IVIG), used alone or combined with corticosteroids in 40.4% and 32.7% of cases respectively, while 25% of patients received only corticosteroids.Our review suggests that COVID-19-related ITP can be seen even in previously healthy patients. Clinicians must be aware that ITP may appear both in mild and severe COVID-19, at any time during its course. Given that this kind of ITP seems to be associated with a higher bleeding risk, its diagnosis in a clinical scenario such as COVID-19, where anticoagulant therapy is frequently used, may be critical. Treatment with IVIG and/or corticoids is often effective.enCOVID-19ITPantiphospholipid syndromecoronavirusimmune thrombocytopeniasystemic lupus erythematosusCOVID-19GlucocorticoidsHumansImmunoglobulins, IntravenousLupus Erythematosus, SystemicMaleMiddle AgedPlatelet CountPrednisonePurpura, Thrombocytopenic, IdiopathicTreatment Outcomeresearch article34053365Restricted AccessGlucocorticoidesHumanosInmunoglobulinas intravenosasLupus eritematoso sistémicoPersona de mediana edadPrednisonaPúrpura TrombocitopénicaRecuento de plaquetasResultado del tratamiento10.1177/096120332110211611477-0962