Drug-induced immune-mediated thrombocytopenia secondary to sunitinib in a patient with metastatic renal cell carcinoma: a case report

Journal of Medical Case Reports

Mathew K George¹  Zia Ansari¹ 

[1] Department of Medical Oncology, Tamworth Rural Referral Hospital, Locked Mail Bag 9783, 2348, Tamworth, NEMSC NSW, Australia

关键词: Thrombocytopenia;    Sunitinib;    Metastatic renal cell carcinoma;   

Others  :  1181265
DOI  :  10.1186/1752-1947-7-54

 received in 2012-11-10, accepted in 2013-01-24,  发布年份 2013

【 摘 要 】

Introduction

Sunitinib is an oral multi-targeted tyrosine kinase inhibitor approved for first line treatment for metastatic renal cell carcinoma and imatinib-resistant metastatic gastrointestinal stromal tumors. Sunitinib administration can cause myelosuppression resulting in neutropenia and thrombocytopenia. Here we present the case of a patient with metastatic renal cell carcinoma who developed sunitinib-induced immune-mediated thrombocytopenia and who was treated with withdrawal of sunitinib and administration of intravenous immunoglobulin and steroids.

Case presentation

This case report describes a 70-year-old Aboriginal Australian with a diagnosis of metastatic renal cell carcinoma. Three weeks after the initiation of sunitinib he developed epistaxis and was admitted with thrombocytopenia (platelets 7 × 109/L) which was found to be refractory to platelet transfusion. Sunitinib was stopped and he was treated with intravenous immunoglobulin and steroids. His platelet count rapidly improved and returned to baseline in three weeks. Only two cases of sunitinib-induced immune-mediated thrombocytopenia have been described in the literature.

Conclusion

Clinicians should have a high index of suspicion for the potential of immune-mediated thrombocytopenia after the initiation of multi-targeted tyrosine kinase inhibitors such as sunitinib. This is a diagnosis of exclusion and can be safely treated by drug withdrawal.

【 授权许可】

   
2013 Ansari and George; licensee BioMed Central Ltd.

【 图 表 】

Figure 5.

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