scholarly journals Case Report: Oxaliplatin-Induced Immune-Mediated Thrombocytopenia

2018 ◽  
Vol 11 (3) ◽  
pp. 880-882 ◽  
Author(s):  
Elizabeth Pan ◽  
Eric Hsieh ◽  
Caroline Piatek
Keyword(s):  
Case Report ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Immune Thrombocytopenia ◽  
Drug Induced ◽  
Gastrointestinal Malignancies ◽  
Common Cause ◽  
Immune Mediated ◽  
Chemotherapy Agents ◽  
Platinum Derivative

Thrombocytopenia is a frequent complication of cancer may be due to a variety of causes including malignancy itself, acute disease processes, or cancer therapy. Systemic cancer therapy is the most common cause of thrombocytopenia in cancer patients observed nearly two-thirds of patients with solid tumors. Thrombocytopenia with traditional chemotherapy agents is most frequently the result of megakaryocyte cytotoxicity. Oxaliplatin is a platinum derivative commonly used in gastrointestinal malignancies and is associated with drug-induced immune thrombocytopenia.

Beta-Blocker Attenuates Cardiotoxicity Related Anthracycline Usage

2021 ◽  
Vol 104 (8) ◽  
pp. 1389-1392
Keyword(s):  
Side Effects ◽  
Cancer Therapy ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Beta Blocker ◽  
The Other ◽  
Large Numbers ◽  
Therapy Effectiveness ◽  
Chemotherapy Agents

To summarize the recent trials and studies of the role of beta-blocker on the treatment for cancer patients treated with anthracycline to decrease morbidity and mortality rate. Good management of cancer will result in large numbers of cancer survivors. On the other hand, cancer therapy also has side effects, one of which is cardiotoxicity. Cardiotoxicity could reduce therapy effectiveness, hence, increase disease progression and mortality rate. Anthracyclines is one of the chemotherapy agents with cardiotoxicity as a side effect. Beta-blocker has the ability to reduce cardiotoxicity due to anthracyclines usage. Keywords: Beta-blocker; Cardiotoxicity; Anthracyclines

scholarly journals Drug-induced thrombocytopenia: pathogenesis, evaluation, and management

Hematology ◽  
2009 ◽  
Vol 2009 (1) ◽  
pp. 153-158 ◽  
Author(s):  
James N. George ◽  
Richard H. Aster
Keyword(s):  
Single Dose ◽  
Causal Relation ◽  
Severe Thrombocytopenia ◽  
Antithrombotic Agents ◽  
Drug Induced ◽  
Level Of Evidence ◽  
Common Cause ◽  
Fibrinogen Binding ◽  
Immune Mediated ◽  
Drug Dependent

AbstractAlthough drugs are a common cause of acute immune-mediated thrombocytopenia in adults, the drug etiology is often initially unrecognized. Most cases of drug-induced thrombocytopenia (DITP) are caused by drug-dependent antibodies that are specific for the drug structure and bind tightly to platelets by their Fab regions but only in the presence of the drug. A comprehensive database of 1301 published reports describing 317 drugs, available at www.ouhsc.edu/platelets, provides information on the level of evidence for a causal relation to thrombocytopenia. Typically, DITP occurs 1 to 2 weeks after beginning a new drug or suddenly after a single dose when a drug has previously been taken intermittently. However, severe thrombocytopenia can occur immediately after the first administration of antithrombotic agents that block fibrinogen binding to platelet GP IIb-IIIa, such as abciximab, tirofiban, and eptifibatide. Recovery from DITP usually begins within 1 to 2 days of stopping the drug and is typically complete within a week. Drug-dependent antibodies can persist for many years; therefore, it is important that the drug etiology be confirmed and the drug be avoided thereafter.

A Comparison of Two Assays for Platelet Antibodies

1979 ◽  
Author(s):  
J.G. Kelton ◽  
A. Giles ◽  
P.B. Neame ◽  
M. Blajchman ◽  
J. Hirah
Keyword(s):  
Multiple Myeloma ◽  
Immune Thrombocytopenia ◽  
Test System ◽  
Healthy Controls ◽  
Fluorescent Assay ◽  
Drug Induced ◽  
Optimal Method ◽  
Platelet Antibodies ◽  
Immune Mediated ◽  
Fluorescence Test

The optimal method for assaying platelet bound antibody is uncertain. We have compared a fluorescent assay (FA) with a (quantitative) antiglobulin consumption assay for platelet associated IgG (PAIgG) in normals and thrombocytopenics with ITP, SLE, non-immune and drug-induced thrombocytopenia. Forty-eight of 49 hospitalized and healthy controls had normal PAIgG levels by the antiglobulin consumption assay (2.6 ± 0.2 fg IgG/platetet, ± SE, normal 0-5 fg) and the FA was negative in 41. The PAIgG level was elevated (20.0 ± 1.9 fq IgG/platdet) in 42 of 45 determinations on ITP patients. The FA was positive in 21. Positivity in the FA test did not relate closely to PAIgG level. The PAlqG was elevated (29.0 - 7.3) in 14 of 15 assays in thrombocytopenic SLE patients. The FA was positive in 3. The PAIgG level was elevated in all 9 patients with drug-induced thrombocytopenia (42.4 ± 23.2) without addition of the drug to the test system. The FA was positive in 5. In 2 of 12 patients with non-immune thrombocytopenia the PAIgG level was slightly elevated (both patients had multiple myeloma) and the FA was positive in 5. The results suggest that the quantitative antiglobulin consumption assay is more sensitive than the fluorescent assay in the diagnosis of immune mediated throinbocytopenia. The significance of the lack of correlation between positivity in the fluorescence test and the PAIgG levels found in patients with ITP is uncertain.

scholarly journals Immune‐mediated drug‐induced liver injury secondary to Omeprazole: A case report

2020 ◽  
Vol 8 (12) ◽  
pp. 3421-3426 ◽  
Author(s):  
Sara Seife Hassen ◽  
Fateen Ata ◽  
Ammara Bint I Bilal ◽  
Mohamed Salih Ali ◽  
Mahir Petkar ◽  
...  
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Immune Mediated

scholarly journals A Fatal Case of Nafcillin-Induced Hepatotoxicity: A Case Report and the Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mian Bilal Alam ◽  
Amin Kadoura ◽  
Magesh Sathaiah
Keyword(s):  
Case Report ◽  
Liver Biopsy ◽  
Hepatic Injury ◽  
Total Bilirubin ◽  
Fatal Case ◽  
Fulminant Liver Failure ◽  
Drug Induced ◽  
Common Cause ◽  
Extensive Evaluation ◽  
Extensive List

Background. Drug-induced hepatotoxicity (DIH) is quite common, and there are several recommendations for its treatment based upon its etiology. DIH may range from mild and subclinical to fulminant liver failure and death. Even though there is extensive list of drugs causing DIH, antibiotics, as a class of drugs, are the most common cause of DIH. Here, we present a fatal case of nafcillin-induced hepatotoxicity confirmed by liver biopsy, with total bilirubin peaking to 21.8 mg/dl and subsequent further extensive evaluation for hepatic injury turning out to be negative.

Atypical presentation of immune thrombocytopenia (ITP) with multiple somatic complaints without bleeding manifestations

2021 ◽  
Vol 11 (2) ◽  
pp. 43-44
Author(s):  
Bhavna Gupta
Keyword(s):  
Case Report ◽  
Diagnostic Tests ◽  
Immune Thrombocytopenia ◽  
Hematologic Malignancy ◽  
Sudden Onset ◽  
Somatic Complaints ◽  
Atypical Presentation ◽  
Hematologic Disorder ◽  
Immune Mediated ◽  
History Of

Immune Thrombocytopenia (ITP) is a hematologic disorder characterized by immune mediated destruction of platelets leading to isolated thrombocytopenia. It presents as sudden onset of acute self-limiting episodes of bleeds which are usually minor but may present with intracranial hemorrhage. ITP is a clinical diagnosis of exclusion. No confirmatory diagnostic tests are available. Management depends on severity of bleeding rather than platelet counts. Here is a case report of a 16 years old female patient presenting with multiple somatic complaints and no history of bleeding manifestations with isolated thrombocytopenia and hematologic malignancy ruled out.

scholarly journals Severe immune-mediated drug-induced liver injury linked to ibandronate: A case report

2013 ◽  
Vol 59 (5) ◽  
pp. 1139-1142 ◽  
Author(s):  
Nicolas Goossens ◽  
Laurent Spahr ◽  
Laura Rubbia-Brandt
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Immune Mediated

scholarly journals Tuberculosis with Immune Thrombocytopenia an Unusual Association

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 12-12
Author(s):  
Shehab Fareed Mohamed ◽  
Mohammed Alkhatib ◽  
Khaled Elfert ◽  
Ahmed Othman ◽  
Dina Sameh Soliman ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Immune Thrombocytopenia ◽  
English Language ◽  
Conflicts Of Interest ◽  
Bone Marrow Aspiration ◽  
Significant Heterogeneity ◽  
Drug Induced ◽  
Immune Mediated ◽  
Hematological Manifestations ◽  
Idiopathic Thrombocytopenia Purpura

Introduction Tuberculosis (TB) and is the leading infectious cause of death in adult's worldwide.TB can have a wide variety of presentations manifestation. Hematological manifestations of tuberculosis have different forms and one of the rare associated is TB with isolated thrombocytopenia. ITP is relatively common autoimmune bleeding disorder.. However, ITP is very rarely associated with TB with only a few cases reported. Isolated Thrombocytopenia in TB is multifactorial and could be explained by different mechanisms as follows Immune-mediated platelet destruction through antiplatelet antibodies as mycobacterium TB may share antibodies with platelets or platelet-associated immunoglobulin, Tuberculosis-induced hemophagocytosis, Defective platelet production due to bone marrow (BM) infiltration, Hypersplenism, intravascular coagulation, anti-tuberculous treatment (ATT) induced thrombocytopenia. Methodology We reviewed the literature using PubMed, google scholar and English language articles only. We have included all the reported cases of tuberculosis and immune thrombocytopenia if it is associations or initial presentations using the keyword: tuberculosis. Pulmonary tuberculosis, immune thrombocytopenia, Idiopathic thrombocytopenia purpura and we excluded drug induced thrombocytopenia. Our review identified forty-two cases in total, in our review Baseline and clinical characteristics are provided. Results Of the forty-two cases identified, more than one quarter of cases (n=12) were from India; the remainder of the reported cases from thirteen different countries. Gender was nearly equally distributed (males n= 21, females n=20, one case unknown); age ranged from 4 to 74 years. The most reported sites of TB as follows; lung (n=20), disseminated (n=8), lymph nodes (n=6), abdomen (n=4), mediastinum (n=2), spleen (n=1) and knee (n=1). Bone marrow aspiration and biopsy done in 27 cases, three of them (7%) found granuloma and 14 (32%) found to have normal to hyprecellular marrow with increased number of megakaryocytes. Of the forty-two cases, ITP was the first presentation of TB with or without typical TB symptoms and signs in more than three quarters of the cases (n=33), while ITP was discovered in TB patients in routine investigations without obvious bleeding symptoms or signs in only four cases. Hemorrhagic symptoms were reported in most of the cases (n=31), skin manifestations (petechiae/purpura/ecchymosis) being the most common (n=28). The therapeutic approach to TB-associated ITP showed significant heterogeneity with Anti tuberculous treatment and first- and/or second-line treatment for ITP given with or without platelets transfusion. Most of the cases (n=36) achieved full recovery with Anti-tuberculous treatment(ATT) and IVIG ± Steroids. Of the 42 cases, six cases were treated with blood and platelet transfusion for thrombocytopenia which did not normalize the platelet count as thrombocytopenia as expected as this is most likely an immune mediated phenomenon. Conclusion Unfortunately, there are no clear guidelines for management of TB-associated ITP and is anecdotal or observational at best. This highlights the importance of conducting prospective and standardized studies in the future. We found that Anti tuberculous treatment could have play pivotal role in management of ITP in TB Patients. Figure Disclosures No relevant conflicts of interest to declare.

scholarly journals Trombocitopenia Grave Induzida por Fenofibrato

2020 ◽  
Vol 33 (1) ◽  
pp. 58 ◽  
Author(s):  
Ana Clara ◽  
Tiago Martins ◽  
Alexandra Martins ◽  
Ana Baptista ◽  
Mário Lázaro
Keyword(s):  
Immune Thrombocytopenia ◽  
Clinical Case ◽  
Rare Event ◽  
Drug Induced ◽  
Corticosteroid Administration ◽  
Fenofibrate Treatment ◽  
Immune Mediated ◽  
Drug Removal ◽  
Life Threatening ◽  
Purpuric Rash

Drug-induced thrombocytopenia is a common entity in clinical practice. However, having in consideration the severity of the case, it becomes imperative to distinguish non-immune thrombocytopenia from the po-tentially life-threatening immune-mediated forms. The authors report a rare clinical case of a 79-year-old man presenting with purpuric rash and gingival hemorrhage while on fenofibrate treatment (sixth day). The evolu-tion was favorable after drug removal and corticosteroid administration. Drug-associated thrombocytopenia is reported by manufacturers as an extremely rare event. This is the second case report of immune throm-bocytopenia to fenofibrate. The first event was reported for publication in 2015.

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