title: Entecavir-Associated Thrombocytopenia in a Decompensated Cirrhotic Patient: A Case Report and Literature Review.
abstract: Drug-associated thrombocytopenia is common and curable, but there were few reports about entecavir-associated thrombocytopenia.We report here a case of a 65-year-old female patient with decompensated cirrhosis. The patient developed a fatal thrombocytopenia while under entecavir treatment. After she received entecavir treatment for 4 days, the patient's platelet count dropped significantly to 1 × 10/L, accompanied with a manifestation of mild sclera bleeding. All diagnostic data suggested an entecavir-induced immunological thrombocytopenia. The patient eventually fully recovered after treated with daily intravenous immunoglobulin infusions.Actually, there were only a handful of reports that children or adults with chronic hepatitis B developed a thrombocytopenia due to nucleoside analogue medication. Timeliness of intravenous immunoglobulin infusion could stop the fatal bleeding for patients with entecavir-associated immunological thrombocytopenia. Hence, early diagnosis and treatment are recommended. Our case suggested that the platelet count should be monitored regularly in patients with decompensated cirrhosis with underline immunological disease while treated with ETV.
authors.affiliation: From the Department of Gastroenterology and Hepatology (XF); Center for Infectious Diseases (LC, JY, PF), West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Fan
authors.forename: Liyu
authors.initials: L
authors.lastname: Chen
authors.forename: Jingyu
authors.initials: J
authors.lastname: Yang
authors.forename: Ping
authors.initials: P
authors.lastname: Feng
mesh_terms: D000368:Aged; D005260:Female; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D007116:Immunization, Passive; D008103:Liver Cirrhosis / Q000188:drug therapy*; D017093:Liver Failure / Q000188:drug therapy*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy
chemical_list: C413685:entecavir; D006147:Guanine