Generalized sarcoidosis and severe thrombocytopenic purpura: clinical observation and literature review

Sarcoidosis is a disease of an unknown etiology and is characterized by a wide range of clinical manifestations due to granulomatous damage of the lungs and other organs. Hematologic disorders in sarcoidosis are represented by different variants of pancytopenia, while autoimmune thrombocytopenic purpura is rare. Hemorrhagic syndrome with critical thrombocytopenia in blood of a patient with systemic sarcoidosis (damage to the lungs, nervous system, skin) coincided with an episode of a viral infection with symptoms of COVID-19 and the detection of an increased titer of antibodies to SARS-CoV-2 in the blood. In our paper we described the clinical features of the disease, medical treatment. The issues of managing patients with sarcoidosis during a pandemic time are discussed.

Fisher-Evans syndrome. Casereport in physician’s practice

The article presents the clinical features and treatment options for autoimmune thrombocytopenic purpura associated with autoimmune hemolytic anemia in the context of Fisher-Evans syndrome. Patient P. was admitted to the emergency department by an ambulance team with a direct diagnosis of acute pancreatitis. Leading clinical syndromes were hemorrhagic and anemic syndromes. A physical examination also revealed a strip-formed hemorrhagic rash in the area of inguinal folds, the anterior surface of the thighs and lower legs. During the differential diagnostic search, the diagnosis of Fisher-Evans syndrome was established. Initial oral and pulse therapy with prednisone was not effective. The patient received platelet transfusions regularly. When eltrombopag was included in therapy, there was an improvement in the patient’s condition, as well as a tendency to increase the level of platelets. On the 35th day, the patient was discharged from the hospital.We examined various clinical variants of thrombocytopenia, I meet in real clinical practice.