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Terapi thrombopoietin receptor agonist pada pasien immune thrombocytopenia dengan infeksi COVID-19: sebuah laporan kasus

  • I Gede Komang Aditya Permana ,
  • Renny Anggreni Rena ,

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a serious health problem in many parts of the world. COVID-19 may trigger a new presentation of Immune Thrombocytopenia (ITP) or may cause relapse in patients with chronic ITP. Treatment of ITP in COVID-19 patients has the risk of worsening the condition of COVID-19 itself.

Case presentation: A 32-year-old male with a history of chronic Immune Thrombocytopenia (ITP) was confirmed with COVID-19. The condition of ITP is controlled with low-dose steroids, presents with very low platelets, and does not respond to previous treatment; it was later discovered that the patient was infected with COVID-19. COVID-19 is known to aggravate thrombocytopenia in patients with ITP and can lead to new ITP conditions. Recent guidelines state that intravenous immunoglobulin (IvIg) is the first choice in ITP patients who have COVID-19 infection, and thrombopoietin receptor agonist (TPO-RA) was another alternative treatment, in this case, the patient received platelet transfusion therapy and TPO-RA, reported that the patient's platelets were well controlled with the use of TPO-RA and COVID-19 infection also improved with the treatment.

Conclusion: Swift diagnosis is needed to improve the quality of life of patients and minimize the occurrence of potential complications caused by COVID-19 in chronic ITP patients.

 

Latar Belakang: Coronavirus disease 2019 (COVID-19) merupakan masalah kesehatan yang serius di berbagai belahan dunia dan Organisasi Kesehatan Dunia (WHO) telah menetapkan COVID-19 sebagai pandemi. COVID-19 diketahui menyebabkan gejala pernafasan dengan manifestasi ringan hingga berat dan melibatkan berbagai sistem tubuh seperti hematologi, neurologi, dan sistem kekebalan tubuh.

Presentasi kasus: Seorang laki-laki berusia 32 tahun dengan riwayat Immune Thrombocytopenia (ITP) kronis terkonfirmasi mengidap COVID-19. Kondisi ITP dikendalikan dengan steroid dosis rendah dan datang dengan trombosit yang sangat rendah serta tidak merespons pengobatan sebelumnya, kemudian diketahui bahwa pasien tersebut terinfeksi COVID-19. COVID-19 diketahui memperburuk trombositopenia pada pasien ITP dan dapat menyebabkan kondisi ITP baru. Pedoman terbaru menyatakan bahwa imunoglobulin intravena (IvIg) merupakan pilihan pertama pada pasien ITP yang mengalami infeksi COVID-19, dan agonis reseptor trombopoietin (TPO-RA) merupakan pengobatan alternatif lain, dalam hal ini pasien mendapat terapi transfusi trombosit dan TPO-RA. Setelah terapi dilaporkan bahwa trombosit pasien terkontrol dengan baik dengan penggunaan TPO-RA dan infeksi COVID-19 juga membaik dengan pengobatan.

Kesimpulan: Diagnosis yang cepat diperlukan untuk meningkatkan kualitas hidup pasien dan meminimalisir terjadinya potensi komplikasi akibat COVID-19 pada pasien ITP kronis.

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How to Cite

Permana, I. G. K. A., & Rena, R. A. (2024). Terapi thrombopoietin receptor agonist pada pasien immune thrombocytopenia dengan infeksi COVID-19: sebuah laporan kasus . Intisari Sains Medis, 15(1), 355–359. https://doi.org/10.15562/ism.v15i1.1935

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I Gede Komang Aditya Permana
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ISM Journal


Renny Anggreni Rena
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ISM Journal