Drug-induced immune thrombocytopenia (DITP) is an important cause of thrombocytopenia. A 73-year-old man with relapsed rectal carcinoma received S-1, oxaliplatin and bevacizumab combination therapy (SOX+Bev). Dexamethasone was administered as an antiemetic prophylaxis. ⋯ We sequentially omitted any drugs suspected to possibly induce thrombocytopenia and confirmed dexamethasone as the cause of thrombocytopenia. DITP induced by synthetic corticosteroids is very rare and this is the first case report of DITP induced by dexamethasone. Although rare, DITP due to synthetic corticosteroids including dexamethasone should be a differential diagnosis among patients receiving synthetic corticosteroids with thrombocytopenia.
Ryosuke Taguchi, Kenji Tsuchihashi, Yuta Okumura, Michitaka Nakano, Tomoyasu Yoshihiro, Hirofumi Ohmura, Nobuhiro Tsuruta, Fumiyasu Hanamura, Kyoko Yamaguchi, Mamoru Ito, Hiroshi Ariyama, Hitoshi Kusaba, K... more oichi Akashi, and Eishi Baba. less
Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan.
Intern. Med. 2020 Jan 1; 59 (20): 2571-2575.
AbstractDrug-induced immune thrombocytopenia (DITP) is an important cause of thrombocytopenia. A 73-year-old man with relapsed rectal carcinoma received S-1, oxaliplatin and bevacizumab combination therapy (SOX+Bev). Dexamethasone was administered as an antiemetic prophylaxis. On day 2 of the first cycle, thrombocytopenia (8,000/μL) was observed. We sequentially omitted any drugs suspected to possibly induce thrombocytopenia and confirmed dexamethasone as the cause of thrombocytopenia. DITP induced by synthetic corticosteroids is very rare and this is the first case report of DITP induced by dexamethasone. Although rare, DITP due to synthetic corticosteroids including dexamethasone should be a differential diagnosis among patients receiving synthetic corticosteroids with thrombocytopenia.