A case of Fisher-Evans syndrome in a patientwith type 2 diabetes mellitus after COVID-19

Abstract

A 57-year-old female patient with type 2 diabetes was admitted to the hospital with complaints of increasing general weakness, low-grade fever, nausea, lack of appetite, icteric skin and sclera during the last week, the appearance of bruises on the skin and hemorrhages after injections. The patient linked her condition with a history of COVID-19, 2 months before admission. The next day after admission, multiple hemorrhages appeared on the oral mucosa, the blood pressure decreased, and there was a rise in the body temperature. Laboratory data showed Fisher-Evans syndrome signs. Standard treatment was initiated. On the third day, the patient's condition showed progressive deterioration. Despite intensive therapy (plasma and blood transfusion, glucocorticoids pulse-therapy), the patient's status progressively worsened. Hemoglobin level and platelet count continued decreasing, and the signs of cerebral edema developed. On day 4 the patient deceased. The described clinical case is consistent with the literature data on the possibility of developing autoimmune disorders after COVID-19. As more and more patients are currently receiving antiplatelet and anticoagulant medications for various indications, it is important to remember that viral infections can provoke hemolysis.