SEVERE IMMUNE-MEDIATED THROMBOCYTOPENIA AFTER INTRAVITREAL BEVACIZUMAB INJECTION.
Autor: Li, Tianyi; Witteman, Derek T.; Weber, Eric D.; Alexander, Warren L.; Schaber, John D.
Publication year: 2020
Retinal cases & brief reports
issn:1937-1578 1935-1089
doi: 10.1097/ICB.0000000000000687
Abstract:
PURPOSE: To report a case of severe immune-mediated thrombocytopenia after intravitreal bevacizumab administration. METHODS: A 77-year-old man with right-sided macular degeneration received intravitreal bevacizumab. After his third treatment dose, he was hospitalized for symptomatic thrombocytopenia (platelet count of 3 k/μL) and underwent testing to determine the etiology. RESULTS: Initial platelet counts on admission were 3 k/μL, down from 238 k/μL 3 months before. A peripheral smear, coagulation studies, and an abdominal CT were unremarkable. A bone marrow biopsy revealed hypercellular marrow with megakaryocytic hyperplasia. Serum antiplatelet antibody testing identified antibodies against glycoprotein IV and human leukocyte antigens. A total of 13 units of platelets were administered and resulted in no significant response. Treatment with rituximab, romiplostim, and human leukocyte antigen-matched platelets resulted in slow recovery and normalization of platelet counts. CONCLUSION: The case presented shows apparent severe immune-mediated thrombocytopenia after intravitreal bevacizumab administration.
Language: eng
Rights:
Pmid: 29227349
Tags: Humans; Aged; Male; Tomography, X-Ray Computed; Angiogenesis Inhibitors/administration & dosage/adverse effects; Bevacizumab/administration & dosage/*adverse effects; Intravitreal Injections; Macular Degeneration/diagnosis/*drug therapy; Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors; Thrombocytopenia/*chemically induced/immunology
Link: https://pubmed.ncbi.nlm.nih.gov/29227349/
