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Correspondence
Exacerbation of immune thrombocytopenia triggered by COVID-19 in patients with systemic lupus erythematosus
  1. Yasushi Kondo1,
  2. Yuko Kaneko1,
  3. Tatsuhiro Oshige1,
  4. Hiroyuki Fukui1,
  5. Shuntaro Saito1,
  6. Mikio Okayama2,
  7. Hirofumi Kamata3,
  8. Makoto Ishii3,
  9. Naoki Hasegawa4,
  10. Koichi Fukunaga3,
  11. Tsutomu Takeuchi1
  1. 1 Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
  2. 2 Division of Haematology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
  3. 3 Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
  4. 4 Department of Infectious Diseases, Center for Infection Diseases and Infection Control, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
  1. Correspondence to Dr Yasushi Kondo, Department of Rheumatology, Keio University School of Medicine, Tokyo 160-8582, Japan; yasutonko{at}a8.keio.jp

https://doi.org/10.1136/annrheumdis-2020-218157

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    We read the article regarding COVID-19 in patients with systemic lupus erythematosus (SLE) by Mathian et al 1 with great interest. We would like to report a case with SLE with COVID-19 who presented severe relapse of thrombocytopaenia. Mild thrombocytopaenia during COVID-19 is frequently observed, and immune thrombocytopaenia (ITP) has also been reported.2 3 Management of ITP during active COVID-19 can be difficult as immunosuppressive therapies can exacerbate infections, and the recovery of platelet count may lead to thrombosis due to coagulopathy caused in COVID-19.4 Here, we report a case with severe ITP relapse in patients with SLE during a course of COVID-19.

    A 58-year-old woman with a nearly 20-year history of SLE was admitted to our hospital with COVID-19. Her main manifestation of SLE was ITP, and her platelet count was low but stable at approximately 60×109/ L with 5 mg of prednisolone (PSL) since the …

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