Wu C, Zhou XM, Liu XD. Eltrombopag-related renal vein thromboembolism in a patient with immune thrombocytopenia: A case report. World J Clin Cases 2021; 9(11): 2611-2618 [PMID: 33889627 DOI: 10.12998/wjcc.v9.i11.2611]
Corresponding Author of This Article
Xiao-Dong Liu, MD, Clinical Pharmacist, Department of Pharmacy, Shengjing Hospital of China Medical University, No. 36 San Hao Street, Shenyang 110004, Liaoning Province, China. liuxdcmu@163.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2021; 9(11): 2611-2618 Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2611
Eltrombopag-related renal vein thromboembolism in a patient with immune thrombocytopenia: A case report
Cen Wu, Xiao-Ming Zhou, Xiao-Dong Liu
Cen Wu, Xiao-Ming Zhou, Department of Respiratory and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Xiao-Dong Liu, Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Wu C and Zhou XM were responsible for the diagnosis and treatment of the patient; Wu C contributed to the data collection and patient follow-up and wrote the manuscript; all authors have read and approved the final manuscript.
Supported byThe Natural Science Funding Guidance Project of Liaoning Province, No. 2018011494-301; and 345 Talent Program of Shengjing Hospital, China Medical University.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors of this paper have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Dong Liu, MD, Clinical Pharmacist, Department of Pharmacy, Shengjing Hospital of China Medical University, No. 36 San Hao Street, Shenyang 110004, Liaoning Province, China. liuxdcmu@163.com
Received: December 9, 2020 Peer-review started: December 9, 2020 First decision: December 24, 2020 Revised: January 9, 2021 Accepted: February 22, 2021 Article in press: February 22, 2021 Published online: April 16, 2021 Processing time: 109 Days and 20.2 Hours
Abstract
BACKGROUND
Eltrombopag is an orally administered thrombopoietin receptor agonist linked to a heightened risk of treatment-related thromboembolism. Both venous and arterial thromboses have been documented in the medical literature.
CASE SUMMARY
In the absence of nephropathy, a 48-year-old patient receiving eltrombopag for immune thrombocytopenia (ITP) developed renal vein thrombosis and pulmonary embolism. The renal vein thrombus spontaneously resolved during subsequent anticoagulant treatment, restoring venous circulation.
CONCLUSION
A rapid upsurge in platelets, rather than their absolute number, may trigger thrombotic events in this setting. For patients at high thrombotic risk, individualized eltrombopag dosing and vigilance in platelet monitoring are perhaps needed during treatment of ITP.
Core Tip: Eltrombopag is a thrombopoietin receptor agonist carrying an increased risk of treatment-related thromboembolism. Reports implicating both venous and arterial thromboses have appeared in the medical literature. Herein, we describe a patient with immune thrombocytopenia but no signs of nephropathy who developed renal vein thrombosis and pulmonary embolism while receiving eltrombopag. During subsequent anticoagulant treatment, the renal vein thrombus spontaneously resolved, restoring venous circulation. A rapid upsurge in platelets (as opposed to their absolute count) may be the chief determinant of such thrombotic events during cytopenic downturns.
