Aplastic Anemia With Thrombosis Following the Administration of Immunosuppressant and Thrombopoietin Receptor Agonist (TPO-RA)
Thrombopoietin receptor agonist (TPO-RA) is effective for aplastic anemia (AA) and idiopathic thrombocytopenic purpura (ITP). However, the risk of thrombosis during ITP treatment with TPO-RA is higher than without TPO-RA. It is unclear whether TPO-RA increases the risk of thrombosis in patients with...
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| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2024-05, Vol.16 (5), p.e61135 |
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| creator | Iino, Tadafumi Yokoo, Masako Okamoto, Sho Kondo, Seiji |
| description | Thrombopoietin receptor agonist (TPO-RA) is effective for aplastic anemia (AA) and idiopathic thrombocytopenic purpura (ITP). However, the risk of thrombosis during ITP treatment with TPO-RA is higher than without TPO-RA. It is unclear whether TPO-RA increases the risk of thrombosis in patients with AA. We report a case of a 66-year-old female with severe AA having paroxysmal nocturnal hemoglobinuria (PNH) clones in the peripheral blood who developed ischemic colitis after three days of starting eltrombopag. Contrast-enhanced computed tomography showed ischemic colitis and contrast enhancement defect in the left atrial appendage, which indicated a thrombus in the heart. Stopping eltrombopag and providing supportive care improved her symptoms, and her blood cell counts gradually increased. Thrombosis should be considered when TPO-RA is administered during the immunosuppressive treatment of AA. |
| doi_str_mv | 10.7759/cureus.61135 |
| format | Article |
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However, the risk of thrombosis during ITP treatment with TPO-RA is higher than without TPO-RA. It is unclear whether TPO-RA increases the risk of thrombosis in patients with AA. We report a case of a 66-year-old female with severe AA having paroxysmal nocturnal hemoglobinuria (PNH) clones in the peripheral blood who developed ischemic colitis after three days of starting eltrombopag. Contrast-enhanced computed tomography showed ischemic colitis and contrast enhancement defect in the left atrial appendage, which indicated a thrombus in the heart. Stopping eltrombopag and providing supportive care improved her symptoms, and her blood cell counts gradually increased. 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Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024, Iino et al. 2024 Iino et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c267t-1c6cb845637f56f28a6f96c765927ea09c0c92b878662d231cfd1a7d4f3f92a03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11128314/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11128314/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27915,27916,53782,53784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38800784$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iino, Tadafumi</creatorcontrib><creatorcontrib>Yokoo, Masako</creatorcontrib><creatorcontrib>Okamoto, Sho</creatorcontrib><creatorcontrib>Kondo, Seiji</creatorcontrib><title>Aplastic Anemia With Thrombosis Following the Administration of Immunosuppressant and Thrombopoietin Receptor Agonist (TPO-RA)</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Thrombopoietin receptor agonist (TPO-RA) is effective for aplastic anemia (AA) and idiopathic thrombocytopenic purpura (ITP). 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Thrombosis should be considered when TPO-RA is administered during the immunosuppressive treatment of AA.</description><subject>Abdomen</subject><subject>Anemia</subject><subject>Blood clots</subject><subject>Blood diseases</subject><subject>Blood platelets</subject><subject>Blood pressure</subject><subject>Blood tests</subject><subject>Bone marrow</subject><subject>Cardiac arrhythmia</subject><subject>Case reports</subject><subject>Hematology</subject><subject>Hemoglobin</subject><subject>Inflammatory bowel disease</subject><subject>Internal Medicine</subject><subject>Ischemia</subject><subject>Laboratories</subject><subject>Leukocytes</subject><subject>Lymphocytes</subject><subject>Medical imaging</subject><subject>Neutrophils</subject><subject>Proteins</subject><subject>Stem cells</subject><subject>Steroids</subject><subject>Therapeutics</subject><subject>Thrombocytopenia</subject><subject>Thrombosis</subject><subject>Toxins</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpVkc1L7TAQxYM8UVF3riXg5glW89Em6UqK-AWCIldchtw0uTfSJjVJFTfvb3_Vq6KrGZgzvznDAWAPo2POq_pEj9GM6ZhhTKs1sEUwE4XAovzzo98Euyk9IYQw4gRxtAE2qRAIcVFugX_N0KmUnYaNN71T8NHlJZwtY-jnIbkEL0LXhVfnFzAvDWza3nmXclTZBQ-Dhdd9P_qQxmGIJiXlM1S-_QIMwZnsPLw32gw5RNgswvs6_Du7uy3um8MdsG5Vl8zuZ90GDxfns7Or4ub28vqsuSk0YTwXWDM9F2XFKLcVs0QoZmumOatqwo1CtUa6JnPBBWOkJRRr22LF29JSWxOF6DY4XXGHcd6bVhs_vdDJIbpexTcZlJO_J94t5SK8SIwxERSXE-HgkxDD82hSlk9hjH4yLSliRBAhBJ5URyuVjiGlaOz3CYzke2JylZj8SGyS7_-09S3-yof-B1gGlR4</recordid><startdate>20240526</startdate><enddate>20240526</enddate><creator>Iino, Tadafumi</creator><creator>Yokoo, Masako</creator><creator>Okamoto, Sho</creator><creator>Kondo, Seiji</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20240526</creationdate><title>Aplastic Anemia With Thrombosis Following the Administration of Immunosuppressant and Thrombopoietin Receptor Agonist (TPO-RA)</title><author>Iino, Tadafumi ; 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| source | PubMed Central Open Access; PubMed Central |
| subjects | Abdomen Anemia Blood clots Blood diseases Blood platelets Blood pressure Blood tests Bone marrow Cardiac arrhythmia Case reports Hematology Hemoglobin Inflammatory bowel disease Internal Medicine Ischemia Laboratories Leukocytes Lymphocytes Medical imaging Neutrophils Proteins Stem cells Steroids Therapeutics Thrombocytopenia Thrombosis Toxins |
| title | Aplastic Anemia With Thrombosis Following the Administration of Immunosuppressant and Thrombopoietin Receptor Agonist (TPO-RA) |
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