Cerebral Venous Thrombosis in a Patient with Immune Thrombocytopenia, an Apparent Paradox

We present a paradoxical case of immune thrombocytopenia (ITP) that presented with cerebral venous thrombosis. A 39-year-old female patient diagnosed with chronic ITP, who failed treatment on multiple-line agents, was started on eltrombopag (thrombopoietin receptor agonist), which she was not compli...

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Bibliographic Details
Published in:Case reports in oncology 2020-06, Vol.13 (2), p.588-594
Main Authors: Rasheed, Maimoonah A., Alsaud, Arwa E., Razzaq, Sania, Fadul, Afraa, Yassin, Mohamed A.
Format: Article
Language:English
Subjects:
Anticoagulants
anticoagulation
Antigens
Blood clots
Blood platelets
Case Report
Case reports
cerebral venous thrombosis
Defects
drug therapy
Growth factors
Hemorrhage
immune thrombocytopenia
Intensive care
Laboratories
Magnetic resonance imaging
Medical imaging
Patients
Pregnancy
side effects
Sinuses
Thrombocytopenia
Thrombosis
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Summary:We present a paradoxical case of immune thrombocytopenia (ITP) that presented with cerebral venous thrombosis. A 39-year-old female patient diagnosed with chronic ITP, who failed treatment on multiple-line agents, was started on eltrombopag (thrombopoietin receptor agonist), which she was not compliant to. The patient later developed extensive cerebral venous thrombosis, along with venous infarcts, and intracranial and subarachnoid hemorrhage. She was treated with intravenous immunoglobulins as well as steroid therapy and was simultaneously started on anticoagulation. The patient improved clinically and radiologically. This case is among few reported cases which signify that patients with ITP are inherently prone to thrombosis despite low platelet count and treating these patients can be a dilemma. Judicious use of anticoagulation and immunosuppressive therapy is recommended based on available evidence pending further recommendations and guidelines about treatment of thrombosis in ITP.
ISSN:1662-6575
1662-6575
DOI:10.1159/000507389