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Case reports
Drug-induced immune-mediated thrombocytopenia due to bevacizumab-FOLFOX therapy: a case report
Minna Kim, Jong Hoon Lee, Jong Yoon Lee
Kosin Med J. 2023;38(4):300-306.   Published online July 28, 2023
DOI: https://doi.org/10.7180/kmj.23.121
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Abstract PDFPubReader   ePub   
Drug-induced immune thrombocytopenia (DITP) is a very rare disease, with an estimated annual incidence of 10 cases per million. Oxaliplatin and irinotecan are widely used as chemotherapy for high-risk stage II and III colorectal cancer, and DITP has been reported to occur in patients using those agents. To treat unresectable metastatic colorectal cancer, bevacizumab is used in combination with oxaliplatin or irinotecan, and there have been a few reports of DITP cases in patients receiving that regimen. In this report, we describe a 68-year-old male patient with metastatic colon cancer (KRAS mutant type) to the liver and lung who developed acute immune-mediated thrombocytopenia due to bevacizumab-FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) therapy. During treatment, he showed purpura in his lower extremities on 21st cycle day 2. Lab work revealed a platelet count of less than 2,000/mL, reflecting a decrease from 135,000/mL at the start of the cycle 1 day prior. He did not have any other types of cytopenia or significant changes in laboratory findings. We diagnosed DITP due to bevacizumab-FOLFOX, and the patient did not show isolated thrombocytopenia after switching to Ziv-aflibercept-FOLFIRI (5-fluorouracil, leucovorin, and irinotecan).
A Case of Treatment with Steroid and Hydrochloroquine of Thrombocytopenia in Primary Sjögren's Syndrome
Yeong Seop Yun, Ji Wook Choi, Young Jae Doo, Tae Hyung Kim, Hye Lim Oh, Ji Min Oh
Kosin Med J. 2017;32(1):118-126.   Published online June 30, 2017
DOI: https://doi.org/10.7180/kmj.2017.32.1.118
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Abstract PDFPubReader   ePub   

Sjögren's syndrome is a systemic autoimmune disease characterized by sicca symptoms and extraglandular manifestations. Anemia, leukopenia, thrombocytopenia and lymphoproliferative disorders are well-known extraglandular, hematological complications of Sjögren's syndrome. These hematologic alterations are usually mild and respond well with steroid therapy. We report a case of a 52-year-old female patient who was initially presented with thrombocytopenia. The patient was then diagnosed with primary Sjögren's syndrome and initially treated with steroid. The patient's platelet count was decreased when steroid was tapered. The dose of steroid could be effectively reduced after combined medication with hydroxychloroquine.

A Case of Delivery in Severe Gestational Thrombocytopenia
Tae Hwa Lee, Chun June Lee
Kosin Med J. 2007;22(2):195-198.   Published online December 31, 2007
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