Radiology Case Reports (Jun 2023)

Immune thrombocytopenia and cerebral thrombophlebitis in a patient on eltrombopag: A rare complication

  • Salma Fares, MD,
  • Omar Halloumi, MD,
  • Soukaina Wakrim, MD,
  • Abdelhamid Maqsodi, MD,
  • Adel Elmekkaoui, MD,
  • Othmane Benlenda, MD,
  • Hicham Nassik, MD

Journal volume & issue
Vol. 18, no. 6
pp. 2069 – 2072

Abstract

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Thrombopoietin receptor analogs (TPO-RAs) are indicated for splenectomized immune thrombocytopenia refractory to corticosteroids or immunoglobulins, intravenous, or as second-line therapy when splenectomy is contraindicated. Herein, we report a case of left transverse and superior sagittal sinus thrombophlebitis in a 49-year-old woman with chronic immune thrombocytopenia who received 10 days of eltrombopag treatment. Etiologic assessment ruled out acquired thrombophilia and antiphospholipid syndrome. Pharmacovigilance investigation confirmed causality between eltrombopag and the cerebral events, necessitating the definitive discontinuation of the drug. The patient was treated with anticoagulants and anticonvulsants. This evolution was marked by clinical recovery and significant radiological improvement of the thrombotic event. Cerebral venous thrombophlebitis within TPO-RA treatment remains rare, and without codified recommendations, a strict assessment of patients at risk of thrombotic events remains necessary prior to TPO-RA initiation.

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