Abstract
Immune Thrombocytopenia (ITP) which is a common, acquired and autoimmune disease is defined as low platelet count secondary to increased platelet destruction or impaired thrombopoiesis by anti-thromboycte antibodies. Pregnancy-associated thrombocytopenia accounts for 5% of all the cases. Thrombopoietin (TPO) mimetic drugs, such as Eltrombopag, have been used successfully in many patients with ITP; however data on its use in pregnancy is limited. In this report, a case who was followed up with ITP and given Eltrombopag during her pregnancy, cause it could not have been controlled by any other treatment is presented. Enoxaparin therapy was iniatiated for thromboprophylaxis after the patient’s platelet count responded to Eltrombopag treatment. Delivery was carried out by cesarean section. Baby was born with low birth weight and there was not any malformation. Nevertheless, further research is needed to find out whether there is a relationship between Eltrombopag use in pregnancy and low birth weight.
References
- 1. George JN, Woolf SH, Raskob GE. Idiopathic thrombocytopenic purpura: A guideline for diagnosis and management of children and adults. American Society of Hematology. Ann Med. 1998;30:38–44
- 2. Loustau V, Pourrat O, Mandelbrot L, Godeau B. Immune thrombocytopenia and pregnancy: state of knowledge and unanswered questions. Rev Med Interne 2015;36(3):167–72.
- 3. Sun D, Shehata N, Ye XY. Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy. Blood 2016;128(10):1329–35.
- 4. Gernsheimer T, James AH, Stasi R, How I treat thrombocytopeniain pregnancy. Blood. 2013;121(1):38-47.
- 5. González-López TJ, Fernández-Fuertes F, Hernández-Rivas JA, Sánchez-González B, Martínez-Robles V, Alvarez-Román MT, et al. Efficacy and safety of eltrombopag in persistent and newly diagnosed ITP in clinical practice. Int J Hematol. 2017;106:508–16.
- 6. Ferreira IJMCF, Sousa F, Vasco EM, Areia ALFA, Moura JPAS, CardJ, et al. J Gynecol Obstet Hum Reprod. 2018 Oct;47(8):405-408.
- 7. Suzuki N, Hiraga J, Hariyama Y, Takagi Y, Ohashi H, Kishigami Y, et al. Int J Hematol. 2018 Jul;108(1):109-111.
- 8. Purushothaman J, Puthumana KJ, Kumar A, Innah SJ, Gilvaz S. Asian J Transfus Sci. 2016 Jul-Dec;10(2):155-8.
- 9. Letsky EA, Greaves M. Guidelines on the investigation and management of thrombocytopenia in pregnancy and neonatal alloimmune thrombocytopenia. Maternal and Neonatal Haemostasis Working Party of the Haemostasis and Thrombosis Task Force of the British Society for Haematology. Br J Haematol. 1996;95:21–6.
Abstract
Immune Thrombocytopenia (ITP) which is a common, acquired and autoimmune disease is defined as low platelet count secondary to increased platelet destruction or impaired thrombopoiesis by anti-thromboycte antibodies. Pregnancy-associated thrombocytopenia accounts for 5% of all the cases. Thrombopoietin (TPO) mimetic drugs, such as Eltrombopag, have been used successfully in many patients with ITP; however data on its use in pregnancy is limited. In this report, a case who was followed up with ITP and given Eltrombopag during her pregnancy, cause it could not have been controlled by any other treatment is presented. Enoxaparin therapy was iniatiated for thromboprophylaxis after the patient’s platelet count responded to Eltrombopag treatment. Delivery was carried out by cesarean section. Baby was born with low birth weight and there was not any malformation. Nevertheless, further research is needed to find out whether there is a relationship between Eltrombopag use in pregnancy and low birth weight.
References
- 1. George JN, Woolf SH, Raskob GE. Idiopathic thrombocytopenic purpura: A guideline for diagnosis and management of children and adults. American Society of Hematology. Ann Med. 1998;30:38–44
- 2. Loustau V, Pourrat O, Mandelbrot L, Godeau B. Immune thrombocytopenia and pregnancy: state of knowledge and unanswered questions. Rev Med Interne 2015;36(3):167–72.
- 3. Sun D, Shehata N, Ye XY. Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy. Blood 2016;128(10):1329–35.
- 4. Gernsheimer T, James AH, Stasi R, How I treat thrombocytopeniain pregnancy. Blood. 2013;121(1):38-47.
- 5. González-López TJ, Fernández-Fuertes F, Hernández-Rivas JA, Sánchez-González B, Martínez-Robles V, Alvarez-Román MT, et al. Efficacy and safety of eltrombopag in persistent and newly diagnosed ITP in clinical practice. Int J Hematol. 2017;106:508–16.
- 6. Ferreira IJMCF, Sousa F, Vasco EM, Areia ALFA, Moura JPAS, CardJ, et al. J Gynecol Obstet Hum Reprod. 2018 Oct;47(8):405-408.
- 7. Suzuki N, Hiraga J, Hariyama Y, Takagi Y, Ohashi H, Kishigami Y, et al. Int J Hematol. 2018 Jul;108(1):109-111.
- 8. Purushothaman J, Puthumana KJ, Kumar A, Innah SJ, Gilvaz S. Asian J Transfus Sci. 2016 Jul-Dec;10(2):155-8.
- 9. Letsky EA, Greaves M. Guidelines on the investigation and management of thrombocytopenia in pregnancy and neonatal alloimmune thrombocytopenia. Maternal and Neonatal Haemostasis Working Party of the Haemostasis and Thrombosis Task Force of the British Society for Haematology. Br J Haematol. 1996;95:21–6.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Studies |
| Authors | |
| Publication Date | April 30, 2022 |
| Submission Date | June 29, 2021 |
| Published in Issue | Year 2022 Volume: 36 Issue: 1 |
