title: Plateletpheresis for postsplenectomy rebound thrombocytosis in a patient with chronic immune thrombocytopenic purpura on romiplostim.
abstract: Immune thrombocytopenic purpura (ITP) is an autoimmune disease in which IgG-coated platelets are removed from circulation by the spleen, and platelet production is impaired due to increased thrombopoietin (TPO) clearance. Romiplostim, a novel TPO-mimetic agent, is approved for patients with ITP that are unresponsive to traditional treatments. However, there is little experience when using this drug before splenectomy. We describe herein the case of a young female with chronic ITP who was treated with romiplostim, underwent splenectomy shortly thereafter, and required plateletpheresis for postoperative rebound thrombocytosis with concomitant neurologic symptoms.
authors: Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599, USA. jay_raval@med.unc.edu
authors: Jay S
authors: JS
authors: Raval
authors: Robert L
authors: RL
authors: Redner
authors: Joseph E
authors: JE
authors: Kiss
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D010983:Plateletpheresis; D011183:Postoperative Complications / Q000628:therapy*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D011961:Receptors, Fc / Q000627:therapeutic use*; D053628:Receptors, Thrombopoietin / Q000819:agonists*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D013156:Splenectomy / Q000009:adverse effects*; D013922:Thrombocytosis / Q000628:therapy*; D013926:Thrombopoietin / Q000627:therapeutic use*
chemical_list: D011961:Receptors, Fc; D053628:Receptors, Thrombopoietin; D011993:Recombinant Fusion Proteins; D013926:Thrombopoietin; C488777:romiplostim
keywords: ITP; immune thrombocytopenic purpura; plateletpheresis; romiplostim; splenectomy