Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report
Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by antigen-specific T cells and antiplatelet autoantibodies that inhibit platelet production in the bone marrow or destroy platelets in the spleen. ITP is a form of autoimmunity and is closely associated with inflammation. Corti...
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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/9/1645 |
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| author | Eman Mostafa Hamed 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 Hoda Rabea |
| author_facet | Eman Mostafa Hamed 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 Hoda Rabea |
| author_sort | Eman Mostafa Hamed |
| collection | DOAJ |
| description | Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by antigen-specific T cells and antiplatelet autoantibodies that inhibit platelet production in the bone marrow or destroy platelets in the spleen. ITP is a form of autoimmunity and is closely associated with inflammation. Corticosteroids are the first-line therapy for ITP, with a total response rate of 53–80%. However, corticosteroid therapy is associated with significant side effects and is often ineffective in patients with corticosteroid-resistant or -intolerant disease. Eltrombopag has been validated as a second-line option in ITP therapy. Despite several studies demonstrating the efficacy and safety of Eltrombopag in immune thrombocytopenia patients, the prevalence of Eltrombopag-induced acute kidney injury has been observed. This case report describes a patient who experienced acute kidney injury during Eltrombopag therapy. A sudden increase in serum creatinine to 6.7 mg/dL and metabolic acidosis occurred after eight weeks of Eltrombopag. The patient’s renal failure had worsened, proteinuria was detected, and emergency hemodialysis was initiated. With vigilant kidney function screening and prompt treatment, the patient’s renal function improved remarkably following cessation of Eltrombopag and initiation of hemodialysis. This case highlights the importance of comprehensive medication history-taking and vigilant kidney function screening in patients receiving Eltrombopag. |
| first_indexed | 2024-03-10T22:29:03Z |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T22:29:03Z |
| publishDate | 2023-09-01 |
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| record_format | Article |
| series | Medicina |
| spelling | doaj.art-6f82af1624b144898dc1257ddc17728e2023-11-19T11:52:52ZengMDPI AGMedicina1010-660X1648-91442023-09-01599164510.3390/medicina59091645Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case ReportEman Mostafa Hamed0Mohamed Hussein Meabed1Ahmed R. N. Ibrahim2Ahmed M. Khalaf3Doaa Mohamed El Demerdash4Marwa O. Elgendy5Haitham Saeed6Tamer M. Mahmoud7Heba F. Salem8Hoda Rabea9Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62521, EgyptDepartment of Pediatrics and Hematology, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, EgyptDepartment of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi ArabiaDepartment of Internal Medicine and Clinical Hematology, Beni-Suef University, Beni-Suef 62521, EgyptDepartment of Internal Medicine and Clinical Hematology, Faculty of Medicine, Cairo University, Giza 54212, EgyptDepartment of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62521, EgyptClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62521, EgyptInternal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, EgyptDepartment of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62521, EgyptClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62521, EgyptImmune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by antigen-specific T cells and antiplatelet autoantibodies that inhibit platelet production in the bone marrow or destroy platelets in the spleen. ITP is a form of autoimmunity and is closely associated with inflammation. Corticosteroids are the first-line therapy for ITP, with a total response rate of 53–80%. However, corticosteroid therapy is associated with significant side effects and is often ineffective in patients with corticosteroid-resistant or -intolerant disease. Eltrombopag has been validated as a second-line option in ITP therapy. Despite several studies demonstrating the efficacy and safety of Eltrombopag in immune thrombocytopenia patients, the prevalence of Eltrombopag-induced acute kidney injury has been observed. This case report describes a patient who experienced acute kidney injury during Eltrombopag therapy. A sudden increase in serum creatinine to 6.7 mg/dL and metabolic acidosis occurred after eight weeks of Eltrombopag. The patient’s renal failure had worsened, proteinuria was detected, and emergency hemodialysis was initiated. With vigilant kidney function screening and prompt treatment, the patient’s renal function improved remarkably following cessation of Eltrombopag and initiation of hemodialysis. This case highlights the importance of comprehensive medication history-taking and vigilant kidney function screening in patients receiving Eltrombopag.https://www.mdpi.com/1648-9144/59/9/1645autoimmune diseaseimmune thrombocytopeniarelapsedacute kidney injurydrug inducedEltrombopag |
| spellingShingle | Eman Mostafa Hamed 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 Hoda Rabea 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 autoimmune disease immune thrombocytopenia relapsed acute kidney injury drug induced Eltrombopag |
| title | Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report |
| title_full | Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report |
| title_fullStr | Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report |
| title_full_unstemmed | Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report |
| title_short | Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report |
| title_sort | clinical care team s guide for awareness on risk assessment of eltrombopag complicating acute kidney injury in relapsed immune thrombocytopenic patients a case report |
| topic | autoimmune disease immune thrombocytopenia relapsed acute kidney injury drug induced Eltrombopag |
| url | https://www.mdpi.com/1648-9144/59/9/1645 |
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