{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:04:28Z","timestamp":1790989468344,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,15]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>Immune thrombocytopenic purpura (ITP) is characterised by isolated thrombocytopenia which may be idiopathic or due to a secondary aetiology. ITP is being increasingly recognised secondary to SARS-CoV-2 infection in the current pandemic. Here, we report a case of a five-and-a-half-year-old female child on maintenance chemotherapy for acute lymphoblastic leukaemia who subsequently developed ITP secondary to SARS-CoV-2 infection. Our patient had prolonged thrombocytopenia secondary to ITP, requiring the use of second-line agents including romiplostim and eltrombopag. This is a unique case where ITP was recognised secondary to SARS-CoV-2. In such cases of thrombocytopenia, ITP should be considered as an important differential in addition to relapse of leukaemia or thrombocytopenia due to chemotherapy drugs.<\/jats:p>","DOI":"10.1136\/bcr-2021-245869","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T11:00:17Z","timestamp":1636110017000},"page":"e245869","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Immune thrombocytopenic purpura secondary to SARS-CoV-2 infection in a child with acute lymphoblastic leukaemia: a case report and review of literature"],"prefix":"10.1136","volume":"14","author":[{"given":"Amol","family":"Dongre","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Alexis Multispeciality Hospital, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8040-4835","authenticated-orcid":false,"given":"Patel Zeeshan","family":"Jameel","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Department of Pathology, Alexis Multispeciality Hospital, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Bhandarkar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Neonatology, Alexis Multispeciality Hospital, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"2025082707335228000_14.11.e245869.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-07-162503"},{"key":"2025082707335228000_14.11.e245869.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08176.x"},{"key":"2025082707335228000_14.11.e245869.3","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1055\/s-0039-1683416","article-title":"Epidemiology and clinical manifestations of immune thrombocytopenia","volume":"39","author":"Kohli","year":"2019","journal-title":"Hamostaseologie"},{"key":"2025082707335228000_14.11.e245869.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2013.03.001"},{"key":"2025082707335228000_14.11.e245869.5","doi-asserted-by":"publisher","DOI":"10.1038\/nm921"},{"key":"2025082707335228000_14.11.e245869.6","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1080\/17474086.2018.1489720","article-title":"Autoimmune cytopenias in chronic lymphocytic leukemia: a Concise review and treatment recommendations","volume":"11","author":"De Back","year":"2018","journal-title":"Expert Rev Hematol"},{"key":"2025082707335228000_14.11.e245869.7","first-page":"224","article-title":"Immune thrombocytopenia secondary to Hodgkin's lymphoma in children","volume":"22","author":"Tanous","year":"2020","journal-title":"Isr Med Assoc J"},{"key":"2025082707335228000_14.11.e245869.8","doi-asserted-by":"crossref","first-page":"363","DOI":"10.4274\/tjh.2014.0138","article-title":"Immune thrombocytopenic purpura during maintenance phase of acute lymphoblastic leukemia: a rare coexistence requiring a high degree of suspicion, a case report and review of the literature","volume":"32","author":"Bayhan","year":"2015","journal-title":"Turk J Haematol"},{"key":"2025082707335228000_14.11.e245869.9","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1080\/08880010050211457","article-title":"Idiopathic thrombocytopenic purpura in acute lymphocytic leukemia","volume":"17","author":"Yenicesu","year":"2000","journal-title":"Pediatr Hematol Oncol"},{"key":"2025082707335228000_14.11.e245869.10","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/j.1600-0609.1993.tb00642.x","article-title":"Immune thrombocytopenia in association with acute lymphoblastic leukaemia and a haemophagocytic syndrome","volume":"51","author":"Campbell","year":"1993","journal-title":"Eur J Haematol"},{"key":"2025082707335228000_14.11.e245869.11","doi-asserted-by":"crossref","DOI":"10.1007\/s13312-012-0228-9","article-title":"Immune thrombocytopenic purpura with acute lymphoblastic leukemia an unusual association","volume":"49","author":"Dua","year":"2012","journal-title":"Indian Pediatr"},{"key":"2025082707335228000_14.11.e245869.12","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s12185-009-0424-0","article-title":"Refractory chronic immune thrombocytopenic purpura in a child with acute lymphoblastic leukemia","volume":"90","author":"Horino","year":"2009","journal-title":"Int J Hematol"},{"key":"2025082707335228000_14.11.e245869.13","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/01.mph.0000210411.56501.8d","article-title":"Immune thrombocytopenic purpura in a child with acute lymphoblastic leukemia and mumps","volume":"28","author":"Kurekci","year":"2006","journal-title":"J Pediatr Hematol Oncol"},{"key":"2025082707335228000_14.11.e245869.14","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20341"},{"key":"2025082707335228000_14.11.e245869.15","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S0022-3476(79)80582-X","article-title":"Idiopathic thrombocytopenic purpura in acute lymphoblastic leukemia","volume":"94","author":"Rao","year":"1979","journal-title":"J Pediatr"},{"key":"2025082707335228000_14.11.e245869.16","doi-asserted-by":"publisher","DOI":"10.1067\/S0022-3476(03)00245-2"},{"key":"2025082707335228000_14.11.e245869.17","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21978"},{"key":"2025082707335228000_14.11.e245869.18","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1007\/s00277-017-3095-6","article-title":"Life-threatening bleeding episodes in primary immune thrombocytopenia: a single-center retrospective study of 169 inpatients","volume":"96","author":"Tsuda","year":"2017","journal-title":"Ann Hematol"},{"key":"2025082707335228000_14.11.e245869.19","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-04-215525"},{"key":"2025082707335228000_14.11.e245869.20","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.26812","article-title":"Utility of the immature platelet fraction in pediatric immune thrombocytopenia: differentiating from bone marrow failure and predicting bleeding risk","volume":"65","author":"McDonnell","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"2025082707335228000_14.11.e245869.21","first-page":"1","article-title":"Immune thrombocytopenia secondary to COVID-19: a systematic review","author":"Bhattacharjee","year":"2020","journal-title":"SN Compr Clin Med"},{"key":"2025082707335228000_14.11.e245869.22","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/bjh.16885","article-title":"Delayed-phase thrombocytopenia in patients with coronavirus disease 2019 (COVID-19)","volume":"190","author":"Chen","year":"2020","journal-title":"Br J Haematol"},{"key":"2025082707335228000_14.11.e245869.23","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01283-z"},{"key":"2025082707335228000_14.11.e245869.24","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019852418"},{"key":"2025082707335228000_14.11.e245869.25","first-page":"335","article-title":"Rituximab usage in children: a double edged sword","volume":"49","author":"Yadav","year":"2012","journal-title":"Indian Pediatr"},{"key":"2025082707335228000_14.11.e245869.26","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017010660"},{"key":"2025082707335228000_14.11.e245869.27","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000279"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-245869","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:33:58Z","timestamp":1756305238000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-245869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":27,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,5]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bcr-2021-245869"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-245869","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}