title: Cyclosporine A in the treatment of a patient with immune thrombocytopenia accompanied by myelodysplastic syndrome and nephrotic syndrome.
abstract: We describe a complete remission with cyclosporine A in a myelodysplastic syndrome (MDS) patient who had a 9-year history of nephrotic syndrome (NS) due to autoimmune nephritis. A 72-year-old woman with MDS and NS rapidly developed thrombocytopenia with multiple spontaneous bleeding episodes and profound proteinuria. She showed persistent platelet refractoriness to platelet transfusions. A flow cytometry examination strongly detected antiplatelet autoantibodies on the surface of her platelets. The treatment with high-dose corticosteroids and intravenous immunoglobulin did not lead to complete improvement in the platelet count, bleedings and proteinuria. However, a low dose of cyclosporine A resulted in a sustained normal range of blood platelet count and negative proteinuria. This finding suggests that, in selected cases, cyclosporine A can be an attractive alternative for MDS patients who also have immune-mediated diseases.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Our Lady of Mercy Hospital, Catholic University, Inchon, Korea.
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Park
authors.forename: Chi-Wha
authors.initials: CW
authors.lastname: Han
authors.forename: Je-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyeon-Seok
authors.initials: HS
authors.lastname: Eom
authors.forename: Seung-Hun
authors.initials: SH
authors.lastname: Lee
authors.forename: Dae-Chul
authors.initials: DC
authors.lastname: Jeong
authors.forename: Ji-Hyang
authors.initials: JH
authors.lastname: Lim
mesh_terms: D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009190:Myelodysplastic Syndromes / Q000150:complications*; D009404:Nephrotic Syndrome / Q000150:complications*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy*; D012074:Remission Induction
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine