Renal transplant in a patient with idiopathic thrombocytopenic purpura refractory to steroid and intravenous immunoglobulin

oleh: Shubham Agarwal, Pankaj Beniwal, Dhananjai Agarwal, Vinay Rathore

Format: Article
Diterbitkan: Wolters Kluwer Medknow Publications 2019-01-01

Deskripsi

Chronic kidney disease in immune thrombocytopenia (ITP) is uncommon, and renal transplant in this setting is especially rare. We present a case of successful renal transplantation in a patient with chronic ITP refractory to steroid and intravenous immunoglobulin (IVIg). A 27-year-old female suffering from ITP was referred to our center for renal transplant with her mother as a donor. Her platelets count failed to improve despite treatment with prednisolone (1 mg/kg/day for 4 weeks) and IVIg (1 g/kg/day for 2 consecutive days). She was then treated with eltrombopag (50 mg/day), a thrombopoietin receptor agonist, following which her platelet counts improved and allowed kidney transplantation to be performed safely. At 1 year of follow-up, her graft was functioning normally. The case report highlights that renal transplantation is feasible in patients with ITP, even if the disease is refractory to first-line agents. Eltrombopag may be used to increase the platelet count and decrease the risk of bleeding during the peritransplant period.