Balancing Therapy with Thrombopoietin Receptor Agonists and Splenectomy in Refractory Immune Thrombocytopenic Purpura: A Case of Postsplenectomy Thrombocytosis Requiring Plateletpheresis.
Jacquelyn ZimmermanKelly J NorsworthyRobert A BrodskyPublished in: Case reports in hematology (2016)
Immune thrombocytopenic purpura (ITP) causes thrombocytopenia through the autoimmune destruction of platelets. Corticosteroids remain the first line of therapy, and traditionally splenectomy has been the second. While the availability of thrombopoietin receptor agonists (TPO-RAs) has expanded treatment options, there is little data for the ideal management of these agents in preparation for splenectomy. Thrombocytosis has been reported after splenectomy in patients treated with TPO-RA preoperatively, with one prior case requiring plateletpheresis for symptomatic thrombocytosis. We present a case report and review of the literature pertaining to this complication and provide recommendations for preventing postsplenectomy thrombocytosis in ITP patients on TPO-RAs.
Keyphrases
- end stage renal disease
- chronic kidney disease
- ejection fraction
- rheumatoid arthritis
- multiple sclerosis
- prognostic factors
- peritoneal dialysis
- wild type
- recombinant human
- electronic health record
- big data
- mesenchymal stem cells
- bone marrow
- machine learning
- clinical practice
- high resolution
- artificial intelligence
- drug induced