Abstract
Immunosuppressive agents are the standard therapeutic approach for immune thrombocy-topenia (ITP). Their prolonged use may increase the risk of infectious complications, particularly when the patient is already at higher infectious risk. In this setting, the use of drugs with a mechanism of action alternative to immunosuppression, like thrombopoietin receptor agonists (TRAs), may find particular indication. We report the unique case of a patient with severe immunodeficiency and ITP, who experienced a serious infectious complication while on steroids treatment, and who was successfully treated with Romiplostim second-line. The present experience supports the effectiveness and safety of TRAs as early treatment of ITP patients with drug-induced immunodeficiency or with active infections.
Highlights
A 47-year-old man was referred to our department in May 2010 because of isolated severe thrombocytopenia with positivity of antiplatelet antibodies test, in
When the patient recovered from the infectious complication, Romiplostim treatment was initiated with weekly administrations, as per standard protocol
Standard front-line therapy for immune thrombocyn topenia (ITP) are steroids eral nephrectomy occurred for detection of clear, achieving cell renal carcinoma
Summary
Line with prednisone 1 mg/kg/day, obtaining only a transient response of thrombocytopenia (Figure 1). When the patient recovered from the infectious complication, Romiplostim treatment was initiated with weekly administrations, as per standard protocol. Doses were escalated from 1 to 2 g/kg after 2 weeks of treatment because of no response.
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