title: Low dose cepharanthine ameliorates immune thrombocytopenic purpura associated with multiple myeloma.
abstract: Immune thrombocytopenic purpura associated with multiple myeloma is extremely rare. Here, we present the successful management of an elderly Japanese patient with multiple myeloma complicated by immune thrombocytopenia with low dose cepharanthine - a plant derived alkaloid. A 78-year-old male patient with IgGκ multiple myeloma was repetitively treated with melpharan and prednisolone. In each chemotherapy course, we demonstrated a close relationship between platelet recovery and administration of high dose prednisolone. When further chemotherapy was avoided because of the patient's poor general condition, administration of cepharanthine was effective in halting progressive thrombocytopenia due to abnormal immune mechanisms. We propose the usefulness of cepharanthine in management of this rare disease.
authors.affiliation: Department of Internal Medicine, Hyogo Prefectural Tsukaguchi Hospital, 6-8-17 Minamitsukaguchi, Amagasaki, Hyogo, Japan. rtabata@hp.pref.hyogo.jp
authors.forename: Rie
authors.initials: R
authors.lastname: Tabata
authors.forename: Chiharu
authors.initials: C
authors.lastname: Tabata
authors.forename: Ayako
authors.initials: A
authors.lastname: Tazoh
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nagai
mesh_terms: D000368:Aged; D044182:Benzylisoquinolines / Q000008:administration & dosage*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D009101:Multiple Myeloma / Q000150:complications*; D010976:Platelet Count; D011239:Prednisolone / Q000008:administration & dosage; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D052117:Benzodioxoles
chemical_list: D044182:Benzylisoquinolines; D007074:Immunoglobulin G; D008558:Melphalan; D011239:Prednisolone; C006947:cepharanthine; D052117:Benzodioxoles