Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report
Abstract
:1. Introduction
2. A Case Presentation
2.1. Patient’s Past History
2.2. Laboratory Examinations
3. Clinical Management
4. Discussion
5. Conclusions
Case Report Limitation
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Kellum, J.A.; Romagnani, P.; Ashuntantang, G.; Ronco, C.; Zarbock, A.; Anders, H.J. Acute kidney injury. Nat. Rev. Dis. Primers 2021, 7, 52. [Google Scholar] [CrossRef] [PubMed]
- Yerramilli, M.; Farace, G.; Quinn, J.; Yerramilli, M. Kidney disease and the nexus of chronic kidney disease and acute kidney injury: The role of novel biomarkers as early and accurate diagnostics. Vet. Clin. Small Anim. Pract. 2016, 46, 961–993. [Google Scholar] [CrossRef] [PubMed]
- Dal, M.S.; Karakus, A.; Aydin, B.B.; Ekmen, M.O.; Ulas, T.; Ayyildiz, O. Serum uric acid and inflammation in patients with immune thrombocytopenic purpura: Preliminary results. Eur. Rev. Med. Pharmacol. Sci. 2015, 19, 4385–4389. [Google Scholar]
- Lugus, J.J.; Park, C.; Ma, Y.D.; Choi, K. Both primitive and definitive blood cells are derived from Flk-1+ mesoderm. Blood 2009, 113, 563–566. [Google Scholar] [CrossRef] [PubMed]
- Lang, D.; Dohle, F.; Terstesse, M.; Bangen, P.; August, C.; Pauels, H.-G.; Heidenreich, S. Down-regulation of monocyte apoptosis by phagocytosis of platelets: Involvement of a caspase-9, caspase-3, and heat shock protein 70-dependent pathway. J. Immunol. 2002, 168, 6152–6158. [Google Scholar] [CrossRef] [PubMed]
- Song, F.; Al-Samkari, H. Management of adult patients with Immune Thrombocytopenia (ITP): A review on current guidance and experience from clinical practice. J. Blood Med. 2021, 12, 653–664. [Google Scholar] [CrossRef]
- Ayad, N.; Grace, R.F.; Al-Samkari, H. Thrombopoietin receptor agonists and rituximab for treatment of pediatric immune thrombocytopenia: A systematic review and meta-analysis of prospective clinical trials. Pediatr. Blood Cancer 2021, 69, e29447. [Google Scholar] [CrossRef]
- Semple, J.W.; Rebetz, J.; Maouia, A.; Kapur, R. An update on the pathophysiology of immune thrombocytopenia. Curr. Opin. Hematol. 2020, 27, 423–429. [Google Scholar] [CrossRef]
- González-Porras, J.R.; Godeau, B.; Carpenedo, M. Switching thrombopoietin receptor agonist treatments in patients with primary immune thrombocytopenia. Ther. Adv. Hematol. 2019, 10, 2040620719837906. [Google Scholar] [CrossRef]
- Rodeghiero, F.; Stasi, R.; Gernsheimer, T.; Michel, M.; Provan, D.; Arnold, D.M.; Bussel, J.B.; Cines, D.B.; Chong, B.H.; Cooper, N.; et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: Report from an international working group. Blood 2009, 113, 2386–2393. [Google Scholar] [CrossRef]
- Kado, R.; McCune, W.J. Treatment of primary and secondary immune thrombocytopenia. Curr. Opin. Rheumatol. 2019, 31, 213–222. [Google Scholar] [CrossRef] [PubMed]
- Kaur, M.N.; Arnold, D.M.; Heddle, N.M.; Cook, R.J.; Hsia, C.C.; Blostein, M.; Jamula, E.; Sholzberg, M.; Lin, Y.; Kassis, J.; et al. Cost-effectiveness of Eltrombopag vs intravenous immunoglobulin for the perioperative management of immune thrombocytopenia. Blood Adv. 2022, 6, 785–792. [Google Scholar] [CrossRef] [PubMed]
- Provan, D.; Arnold, D.M.; Bussel, J.B.; Chong, B.H.; Cooper, N.; Gernsheimer, T.; Ghanima, W.; Godeau, B.; González-López, T.J.; Grainger, J.; et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenia. Blood Adv. 2019, 3, 3780–3817. [Google Scholar] [CrossRef] [PubMed]
- Hamed, E.M.; Ibrahim, A.R.; Meabed, M.H.; Khalaf, A.M.; El Demerdash, D.M.; Elgendy, M.O.; Saeed, H.; Salem, H.F.; Rabea, H. Therapeutic Outcomes of High Dose-Dexamethasone versus Prednisolone+ Azathioprine, Rituximab, Eltrombopag, and Romiplostim Strategies in Persistent, Chronic, Refractory, and Relapsed Immune Thrombocytopenia Patients. Pharmaceuticals 2023, 16, 1215. [Google Scholar] [CrossRef]
- Yasser, A.; Khasahba, E.O.; Shokeir, M.A.E.R.; El Mabood, S.A. Treatment lines of childhood chronic ITP: A retrospective single-center analysis. Вoпрoсы гематoлoгии/oнкoлoгии и иммунoпатoлoгии в педиатрии 2020, 19, 26–30. [Google Scholar] [CrossRef]
- Cuker, A.; Neunert, C.E. How I treat refractory immune thrombocytopenia. Blood J. Am. Soc. Hematol. 2016, 128, 1547–1554. [Google Scholar] [CrossRef] [PubMed]
- Kuter, D.J.; Gernsheimer, T.B. Thrombopoietin and Platelet Production in Chronic Immune Thrombocytopenia. Hematol. Clin. N. Am. 2009, 23, 1193–1211. [Google Scholar] [CrossRef] [PubMed]
- Sperati, C.J.; Streiff, M.B. Acute renal failure in a patient with antiphospholipid syndrome and immune thrombocytopenic purpura treated with Eltrombopag. Am. J. Hematol. 2010, 85, 724–726. [Google Scholar] [CrossRef]
- Hamed, E.M.; Ibrahim, A.R.N.; Meabed, M.H.; Khalaf, A.M.; El Demerdash, D.M.; Elgendy, M.O.; Saeed, H.; Salem, H.F.; Rabea, H. The Outcomes and Adverse Drug Patterns of Immunomodulators and Thrombopoietin Receptor Agonists in Primary Immune Thrombocytopenia Egyptian Patients with Hemorrhage Comorbidity. Pharmaceuticals 2023, 16, 868. [Google Scholar] [CrossRef]
- Mishra, K.; Pramanik, S.; Jandial, A.; Sahu, K.K.; Sandal, R.; Ahuja, A.; Yanamandra, U.; Kumar, R.; Kapoor, R.; Verma, T.; et al. Real-world experience of Eltrombopag in immune thrombocytopenia. Am. J. Blood Res. 2020, 10, 240–251. [Google Scholar]
- Giordano, P.; Lassandro, G.; Barone, A.; Cesaro, S.; Fotzi, I.; Giona, F.; Ladogana, S.; Miano, M.; Marzollo, A.; Nardi, M.; et al. Use of Eltrombopag in children with chronic immune thrombocytopenia (ITP): A real life retrospective multicenter experience of the Italian Association of Pediatric Hematology and Oncology (AIEOP). Front. Med. 2020, 7, 66. [Google Scholar] [CrossRef] [PubMed]
- Saito, M.; Morioka, M.; Izumiyama, K.; Mori, A.; Kondo, T. Severe Portal Vein Thrombosis During Eltrombopag Treatment Concomitant Splenectomy for Immune Thrombocytopenia. Cureus 2021, 13, e17478. [Google Scholar] [CrossRef] [PubMed]
- Wu, C.; Zhou, X.-M.; Liu, X.-D. Eltrombopag-related renal vein thromboembolism in a patient with immune thrombocytopenia: A case report. World J. Clin. Cases 2021, 9, 2611–2618. [Google Scholar] [CrossRef] [PubMed]
- Teng, C.-J.; Hong, Y.-C.; Chiang, H.-L.; Liu, H.-T.; Liu, C.-J.; Yang, A.-H.; Liu, J.-H.; Wang, W.-S.; Tzeng, C.-H. Focal segmental glomerulosclerosis with acute renal failure associated with Eltrombopag therapy. Pharmacother. J. Hum. Pharmacol. Drug Ther. 2011, 31, 622. [Google Scholar] [CrossRef]
- Ghosh, S.A.; Patrick, J.; Maw, K.Z. Acute kidney injury and nephrotic syndrome associated with Eltrombopag therapy in chronic idiopathic thrombocytopenic purpura. BMJ Case Rep. 2021, 14, e241462. [Google Scholar] [CrossRef] [PubMed]
- Neunert, C.; Terrell, D.R.; Arnold, D.M.; Buchanan, G.; Cines, D.B.; Cooper, N.; Cuker, A.; Despotovic, J.M.; George, J.N.; Grace, R.F.; et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019, 3, 3829–3866. [Google Scholar] [CrossRef] [PubMed]
- Tavakolpour, S.; Aryanian, Z.; Seirafianpour, F.; Dodangeh, M.; Etesami, I.; Daneshpazhooh, M.; Balighi, K.; Mahmoudi, H.; Goodarzi, A. A systematic review on efficacy, safety, and treatment-durability of low-dose rituximab for the treatment of Pemphigus: Special focus on COVID-19 pandemic concerns. Immunopharmacol. Immunotoxicol. 2021, 43, 507–518. [Google Scholar] [CrossRef]
- Visco, C.; Rodeghiero, F.; Romano, A.; Valeri, F.; Merli, M.; Quaresimini, G.; Volpetti, S.; Santi, R.M.; Carli, G.; Lucchini, E.; et al. Eltrombopag for immune thrombocytopenia secondary to chronic lymphoproliferative disorders: A phase 2 multicenter study. Blood 2019, 134, 1708–1711. [Google Scholar] [CrossRef]
- Puavilai, T.; Thadanipon, K.; Rattanasiri, S.; Ingsathit, A.; McEvoy, M.; Attia, J.; Thakkinstian, A. Treatment efficacy for adult persistent immune thrombocytopenia: A systematic review and network meta-analysis. Br. J. Haematol. 2019, 188, 450–459. [Google Scholar] [CrossRef]
- Hodson, E.M.; Hahn, D.; Craig, J.C. Corticosteroids for the initial episode of steroid-sensitive nephrotic syndrome. Pediatr. Nephrol. 2015, 30, 1043–1046. [Google Scholar] [CrossRef]
- Seethapathy, H.; Lee, M.D.; Strohbehn, A.I.; Efe, O.; Rusibamayila, N.; Chute, D.F.; Colvin, R.B.; Rosales, A.I.; Fadden, R.M.; Reynolds, K.L.; et al. Clinical features of acute kidney injury in patients receiving dabrafenib and trametinib. Nephrol. Dial. Transpl. 2022, 37, 507–514. [Google Scholar] [CrossRef] [PubMed]
- Patschan, D.; Patschan, S.; Buschmann, I.; Ritter, O. Loop diuretics in acute kidney injury prevention, therapy, and risk stratification. Kidney Blood Press. Res. 2019, 44, 457–464. [Google Scholar] [CrossRef] [PubMed]
- Nieto, M.; Calvo, G.; Hudson, I.; Feldschreiber, P.; Brown, D.; Lee, C.C.; Lay, G.; Valeri, A.; Abadie, E.; Thomas, A.; et al. The European Medicines Agency review of Eltrombopag (Revolade) for the treatment of adult chronic immune (idiopathic) thrombocytopenic purpura: Summary of the scientific assessment of the Committee for Medicinal Products for Human Use. Haematologica 2011, 96, e33–e40. [Google Scholar] [CrossRef] [PubMed]
- Erickson-Miller, C.L.; Delorme, E.; Tian, S.-S.; Hopson, C.B.; Landis, A.J.; Valoret, E.I.; Sellers, T.S.; Rosen, J.; Miller, S.G.; Luengo, J.I.; et al. Preclinical activity of Eltrombopag (SB-497115), an oral, nonpeptide thrombopoietin receptor agonist. Stem Cells 2009, 27, 424–430. [Google Scholar] [CrossRef] [PubMed]
- Lee, H.S.; Song, C.Y. Effects of TGF-β on podocyte growth and disease progression in proliferative podocytopathies. Kidney Blood Press. Res. 2010, 33, 24–29. [Google Scholar] [CrossRef] [PubMed]
- Kim, T.O.; Despotovic, J.; Lambert, M.P. Eltrombopag for use in children with immune thrombocytopenia. Blood Adv. 2018, 2, 454–461. [Google Scholar] [CrossRef] [PubMed]
- Ninos, J.M.; Jefferies, L.C.; Cogle, C.R.; Kerr, W.G. The thrombopoietin receptor, c-Mpl, is a selective surface marker for human hematopoietic stem cells. J. Transl. Med. 2006, 4, 9. [Google Scholar] [CrossRef]
- Kumamoto, T.; Azuma, E.; Tanaka, M.; Qi, J.; Hirayama, M.; Zhang, S.-L.; Kobayashi, M.; Iwamoto, S.; Komada, Y.; Yamamoto, H.; et al. Human dendritic cells express the thrombopoietin receptor, c-Mpl. Br. J. Haematol. 1999, 105, 1025–1033. [Google Scholar] [CrossRef]
- Seger, D.; Barker, K.; McNaughton, C. Misuse of the Naranjo adverse drug reaction probability scale in toxicology. Clin. Toxicol. 2013, 51, 461–466. [Google Scholar] [CrossRef]
- Kim, Y.-K.; Lee, S.-S.; Jeong, S.-H.; Ahn, J.-S.; Yang, D.-H.; Lee, J.-J.; Kim, H.-J. Efficacy and safety of Eltrombopag in adult refractory immune thrombocytopenia. Blood Res. 2015, 50, 19–25. [Google Scholar] [CrossRef]
- Bidika, E.; Fayyaz, H.; Salib, M.; Memon, A.N.; Gowda, A.S.; Rallabhandi, B.; Cancarevic, I. Romiplostim and Eltrombopag in immune thrombocytopenia as a second-line treatment. Cureus 2020, 12, e9902. [Google Scholar] [CrossRef]
- Burness, C.B.; Keating, G.M.; Garnock-Jones, K.P. Eltrombopag: A review in paediatric chronic immune thrombocytopenia. Drugs 2016, 76, 869–878. [Google Scholar] [CrossRef]
- European Medicines Agency. Revolade (Eltrombopag), Product Information. Available online: https://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/001110/human_med_001322.jsp&mid=WC0b01ac058001d124 (accessed on 1 September 2023).
- Bauman, J.W.; Vincent, C.T.; Peng, B.; Wire, M.B.; Williams, D.D.; Park, J.W. Effect of hepatic or renal impairment on Eltrombopag pharmacokinetics. J. Clin. Pharmacol. 2011, 51, 739–750. [Google Scholar] [CrossRef]
- Garnock-Jones, K.P.; Keam, S.J. Eltrombopag. Drugs 2009, 69, 567–576. [Google Scholar] [CrossRef]
- Garnock-Jones, K.P. Eltrombopag: A review of its use in treatment-refractory chronic primary immune thrombocytopenia. Drugs 2011, 71, 1333–1353. [Google Scholar] [CrossRef] [PubMed]
Serological Test | Result | Reference Range |
---|---|---|
White blood cell count | 17.2 | 4–11 × 109/L |
Platelet count | 235 × 109/L | 150–400 × 109/L |
Serum creatinine | 6.7 | 0.8–1.4 mg/dL |
Serum potassium | 5.6 | 3.4–4.7 mEq/L |
Serum albumin | 18 | 35–50 g/L |
γ-glutamyltransferase | 188 U/L | (5–40) U/L |
Serum lactate dehydrogenase | 354 | (105–333) U/L |
Antinuclear antibodies | Negative (0.5) | (0.0–1.0) |
Anti-neutrophilic cytoplasmic antibodies | Negative | Negative |
Serum protein electrophoresis | Negative for Paraproteins | Negative |
Anti-glomerular basement membrane antibodies | Negative < 3.1 Elia U/mL | (0.0–10.0 Elia U/mL) |
Anti-phospholipase 2 receptor antibody | Negative (<4.6) | <15 |
Serum IgA | 1.34 g/L | (0.8–4.0 g/L) |
Serum IgM | 0.81 g/L | (0.94 g/L) (0.5–2.0 g/L) |
Serum IgG | 9.8 g/L | (6.0–16.0 g/L) |
Complement C3 | 1.09 g/L | (0.75–1.65 g/L) |
Complement C4 | 0.36 g/L | (0.14–0.54 g/L) |
Rheumatoid factor | 17 IU/mL | <30 IU/mL |
Anti-double-stranded DNA (IU/mL) | 15 IU/mL | <30 IU/mL |
Anti-_2-glycoprotein IgG | <20 IU/mL | 11 IU/mL |
Antiphospholipid IgG | <15 U/mL | 6 U/mL |
C-ANCA | <7 U/mL | 1.1 U/mL |
P-ANCA | <7 U/mL | 0.7 U/mL |
Anti-GBM | <7 U/mL | 0.9 U/mL |
Cryoglobulin | Negative | Negative |
Hepatitis B surface antigen | Negative | Negative |
Hepatitis C antibodies | Negative | Negative |
HIV 1 and 2 | Not detected | Negative |
SARS-CoV-2 PCR | Negative | Negative |
Erythrocyte sedimentation (ESR) | 59 mm/h | 0 to 22 mm/h |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Hamed, E.M.; Meabed, M.H.; Ibrahim, A.R.N.; Khalaf, A.M.; El Demerdash, D.M.; Elgendy, M.O.; Saeed, H.; Mahmoud, T.M.; Salem, H.F.; Rabea, H. Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report. Medicina 2023, 59, 1645. https://doi.org/10.3390/medicina59091645
Hamed EM, Meabed MH, Ibrahim ARN, Khalaf AM, El Demerdash DM, Elgendy MO, Saeed H, Mahmoud TM, Salem HF, Rabea H. Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report. Medicina. 2023; 59(9):1645. https://doi.org/10.3390/medicina59091645
Chicago/Turabian StyleHamed, Eman Mostafa, Mohamed Hussein Meabed, Ahmed R. N. Ibrahim, Ahmed M. Khalaf, Doaa Mohamed El Demerdash, Marwa O. Elgendy, Haitham Saeed, Tamer M. Mahmoud, Heba F. Salem, and Hoda Rabea. 2023. "Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report" Medicina 59, no. 9: 1645. https://doi.org/10.3390/medicina59091645