Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2611
Peer-review started: December 9, 2020
First decision: December 24, 2020
Revised: January 9, 2021
Accepted: February 22, 2021
Article in press: February 22, 2021
Published online: April 16, 2021
Processing time: 109 Days and 20.2 Hours
Eltrombopag is an orally administered thrombopoietin receptor agonist linked to a heightened risk of treatment-related thromboembolism. Both venous and arterial thromboses have been documented in the medical literature.
In the absence of nephropathy, a 48-year-old patient receiving eltrombopag for immune thrombocytopenia (ITP) developed renal vein thrombosis and pulmonary embolism. The renal vein thrombus spontaneously resolved during subsequent anticoagulant treatment, restoring venous circulation.
A rapid upsurge in platelets, rather than their absolute number, may trigger thrombotic events in this setting. For patients at high thrombotic risk, individualized eltrombopag dosing and vigilance in platelet monitoring are perhaps needed during treatment of ITP.
Core Tip: Eltrombopag is a thrombopoietin receptor agonist carrying an increased risk of treatment-related thromboembolism. Reports implicating both venous and arterial thromboses have appeared in the medical literature. Herein, we describe a patient with immune thrombocytopenia but no signs of nephropathy who developed renal vein thrombosis and pulmonary embolism while receiving eltrombopag. During subsequent anticoagulant treatment, the renal vein thrombus spontaneously resolved, restoring venous circulation. A rapid upsurge in platelets (as opposed to their absolute count) may be the chief determinant of such thrombotic events during cytopenic downturns.