title: Successful treatment of severe thrombocytopenia with romiplostim in a pregnant patient with systemic lupus erythematosus.
abstract: We present a case of a pregnant woman at 27 weeks of gestation with systemic lupus erythematosus who developed severe thrombocytopenia presenting with melena, epistaxis, gum bleeding and frank hematuria. She was resistant to most treatment modalities, including steroids, intravenous immunoglobulins (IVIG), rituximab, IV cyclophosphamide and eltrombopag. She responded to romiplostim with normalization of her platelet count, which enabled her to be delivered safely at 34 weeks of gestation.
authors.affiliation: Rheumatology Unit, Department of Medicine, Sultan Qaboos University Hospital, Oman. jkalkaabi@hotmail.com
authors.forename: J K
authors.initials: JK
authors.lastname: Alkaabi
authors.forename: S
authors.initials: S
authors.lastname: Alkindi
authors.forename: N Al
authors.initials: NA
authors.lastname: Riyami
authors.forename: F
authors.initials: F
authors.lastname: Zia
authors.forename: L M A
authors.initials: LM
authors.lastname: Balla
authors.forename: S M
authors.initials: SM
authors.lastname: Balla
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D010976:Platelet Count; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000503:physiopathology; D011256:Pregnancy Outcome; D011961:Receptors, Fc / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013926:Thrombopoietin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011961:Receptors, Fc; D011993:Recombinant Fusion Proteins; D013926:Thrombopoietin; C488777:romiplostim