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...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.展开更多
Immune thrombocytopenia(ITP),also known as idiopathic thrombocytopenic purpura,is a hematologic disease in which platelet destruction increases and production decreases,mainly mediated by immunity.However,...Immune thrombocytopenia(ITP),also known as idiopathic thrombocytopenic purpura,is a hematologic disease in which platelet destruction increases and production decreases,mainly mediated by immunity.However,up to now,the pathogenesis of ITP is not clear,which has caused great trouble in treatment.Therefore,this paper intends to review the recent literature on ITP treatment to provide some reference for clinical treatment.This paper combines the evidence of ASH immune thrombocytopenia and the Chinese Guidelines for the Diagnosis and Treatment of Adult primary immune thrombocytopenia(2020 edition).In this paper,the treatment process of ITP was divided into first-line treatment and second-line treatment,and it was concluded that first-line treatment was often used when newly diagnosed with ITP:combination of high-dose dexamethasone and low-dose gamma globulin.However,it should be noted that only 60%-80%of patients responded to first-line treatment,and most of them relapsed during dosing reduction or drug withdrawal.Second-line treatment is recommended in this case.The standard treatment is splenectomy,but due to its uncontrollable nature and side effects,it should be used cautiously.A new treatment approach,thrombogenin receptor agonist,has great development potential,and multidrug combination therapy for ITP has positive clinical significance.展开更多
基金The Natural Science Funding Guidance Project of Liaoning Province,No.2018011494-301345 Talent Program of Shengjing Hospital,China Medical University.
文摘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.
文摘Immune thrombocytopenia(ITP),also known as idiopathic thrombocytopenic purpura,is a hematologic disease in which platelet destruction increases and production decreases,mainly mediated by immunity.However,up to now,the pathogenesis of ITP is not clear,which has caused great trouble in treatment.Therefore,this paper intends to review the recent literature on ITP treatment to provide some reference for clinical treatment.This paper combines the evidence of ASH immune thrombocytopenia and the Chinese Guidelines for the Diagnosis and Treatment of Adult primary immune thrombocytopenia(2020 edition).In this paper,the treatment process of ITP was divided into first-line treatment and second-line treatment,and it was concluded that first-line treatment was often used when newly diagnosed with ITP:combination of high-dose dexamethasone and low-dose gamma globulin.However,it should be noted that only 60%-80%of patients responded to first-line treatment,and most of them relapsed during dosing reduction or drug withdrawal.Second-line treatment is recommended in this case.The standard treatment is splenectomy,but due to its uncontrollable nature and side effects,it should be used cautiously.A new treatment approach,thrombogenin receptor agonist,has great development potential,and multidrug combination therapy for ITP has positive clinical significance.
