title: Resolution of paraneoplastic immune thrombocytopenia following everolimus treatment for metastatic renal cell carcinoma.
abstract: Autoimmune thrombocytopenia is an uncommon but reported paraneoplastic manifestation of renal cell carcinoma (RCC). Treatment usually involves management of the underlying malignancy; however, steroids have shown a benefit in published case reports. Here, we describe a patient with profound thrombocytopenia secondary to metastatic RCC. It was refractory to steroid and intravenous immunoglobulin, but the platelet count improved markedly following initiation of everolimus. The possible explanation includes immunomodulation, tumour lysis or a combination of both effects. This is the first reported case of everolimus used in paraneoplastic thrombocytopenia from RCC. More studies are needed for further investigation of its potential use in secondary immune thrombocytopenia from RCC and perhaps other malignancies.
authors.affiliation: Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Department of Oncology, St Vincent's Hospital, Sydney, New South Wales, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Chan
authors.affiliation: Department of Oncology, St Vincent's Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: R J
authors.initials: RJ
authors.lastname: Epstein
authors.affiliation: Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.|Faculty of Medicine, St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Joseph
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D000068338:Everolimus / Q000627:therapeutic use*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus
keywords: everolimus; paraneoplastic thrombocytopenia; renal cell carcinoma