Severe Persistent Primary Immune Thrombocytopenia, Refractory to Multiple Drugs, including Eltrombopag
Journal Title: Scholars Journal of Medical Case Reports - Year 2014, Vol 2, Issue 1
Abstract
Severe forms of primary immune thrombocytopenia may endanger patients' lives. Since there is no ideal treatment for all patients, the range of drugs available has expanded, especially after recognizing the pathogenetic role of deficient production of platelets and improper level of thrombopoietin. We present the case of a female patient aged 61, symptomatic, with multiple associated diseases, which presented a severe form of persistent primary immune thrombocytopenia, refractory to multiple drugs, including eltrombopag, in which platelet count reached 0/mm3, but who responded to intravenous human immunoglobulins. Subsequently, we performed splenectomy. In this case, platelet destruction dominated the pathogenesis of the disease, not their poor production. The treatment of primary immune thrombocytopenia has to be personalized depending on the particularities of each clinical course. Keywords: eltrombopag, immunoglobulins, melatonin, methylprednisolone, splenectomy, primary immune thrombocytopenia.
Authors and Affiliations
Mihăilă RG, Cipăian RC, Morar S, Cernușcă-Mițariu M, Marchian S, Sabău D
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