Abstract
Thrombocytopenia can be caused by various etiologies, one of which is immune-mediated destruction. Within the realm of immune thrombocytopenia, there can be multiple pathways and mechanisms that lead to platelet destruction. Finding the exact mechanism can be a crucial diagnostic step in deciding the most appropriate treatment of the platelet loss and in the therapeutic planning of a patient’s comorbidities, especially in patients with malignancies. In this case report, we describe a patient with metastatic clear cell renal cell carcinoma who developed acute thrombocytopenia while preparing to initiate therapy for his malignancy.
References
Arnold, D. M., Curtis, B. R., Bakchoul, T., & Platelet Immunology Scientific Subcommittee of the International Society on Thrombosis and Hemostasis (2015). Recommendations for standardization of laboratory testing for drug-induced immune thrombocytopenia: communication from the SSC of the ISTH. Journal of Thrombosis and Haemostasis: JTH, 13(4), 676–678. https://doi.org/10.1111/jth.12852
Arnold, D. M., Nazi, I., Warkentin, T. E., Smith, J. W., Toltl, L. J., George, J. N., & Kelton, J. G. (2013). Approach to the diagnosis and management of drug-induced immune thrombocytopenia. Transfusion Medicine Reviews, 27(3), 137–145. https://doi.org/10.1016/j.tmrv.2013.05.005
Aster, R. H., & Bougie, D. W. (2007). Drug-induced immune thrombocytopenia. New England Journal of Medicine, 357(6), 580–587. https://doi.org/10.1056/NEJMra066469
Aster, R. H., Curtis, B. R., McFarland, J. G., & Bougie, D. W. (2009). Drug-induced immune thrombocytopenia: Pathogenesis, diagnosis, and management. Journal of Thrombosis and Haemostasis: JTH, 7(6), 911–918. https://doi.org/10.1111/j.1538-7836.2009.03360.x
Bougie, D. W., Peterson, J., Rasmussen, M., & Aster, R. H. (2015). Mechanism of quinine-dependent monoclonal antibody binding to platelet glycoprotein IIb/IIIa. Blood, 126(18), 2146–2152. https://doi.org/10.1182/blood-2015-04-643148
Bussel, J., Cooper, N., Boccia, R., Zaja, F., & Newland, A. (2021). Immune thrombocytopenia. Expert Review of Hematology, 14(11), 1013–1025. https://doi.org/10.1080/17474086.2021.1995347
Gauer, R. L., & Braun, M. M. (2012). Thrombocytopenia.American Family Physician, 85(6), 612–622.
George, J. N., & Aster, R. H. (2009). Drug-induced thrombocytopenia: Pathogenesis, evaluation, and management. Hematology/the Education Program of the American Society of Hematology. American Society of Hematology. Education Program, 153–158. https://doi.org/10.1182/ asheducation-2009.1.153
Jurk, K., & Kehrel, B. E. (2005). Platelets: Physiology and biochemistry. Seminars in Thrombosis and Hemostasis, 31(4), 381–392. https://doi.org/10.1055/s-2005-916671
Krauth, M.-T., Puthenparambil, J., & Lechner, K. (2012). Paraneoplastic autoimmune thrombocytopenia in solid tumors. Critical Reviews in Oncology/Hematology, 81(1), 75–81. https://doi.org/10.1016/j.critrevonc.2011.02.004
Liu, X., Liang, X., Liang, J., Li, Y., & Wang, J. (2020). Immune thrombocytopenia induced by immune checkpoint inhibitors in solid cancer: Case report and literature review. Frontiers in Oncology, 10, 530478. https://doi.org/10.3389/fonc.2020.530478
Neunert, C., Terrell, D. R., Arnold, D. M., Buchanan, G., Cines, D. B., Cooper, N.,…Vesely, S. K. (2019). American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Advances, 3(23), 3829–3866. https://doi.org/10.1182/bloodadvances.2019000966
National Cancer Institute. (2023). Renal Cell Cancer Treatment (PDQ)–Health Professional Version. https://www.cancer.gov/types/kidney/hp/kidney-treatment-pdq
Smock, K. J., & Perkins, S. L. (2014). Thrombocytopenia: An update. International Journal of Laboratory Hematology, 36(3), 269–278. https://doi.org/10.1111/ijlh.12214
Uchino, K., Quang, L. V., Enomoto, M., Nakano, Y., Yamada, S., Matsumura, S.,…Takami, A. (2021). Cytopenia associated with copper deficiency. EJHaem, 2(4), 729–737. https://doi.org/10.1002/jha2.278
Vayne, C., Guéry, E.-A., Rollin, J., Baglo, T., Petermann, R., & Gruel, Y. (2020). Pathophysiology and diagnosis of drug-induced immune thrombocytopenia. Journal of Clinical Medicine, 9(7), 2212. https://doi.org/10.3390/jcm9072212
Wong, E. Y., & Rose, M. G. (2012). Why does my patient have thrombocytopenia? Hematology/Oncology Clinics of North America, 26(2), 231–252, vii. https://doi.org/10.1016/j.hoc.2012.02.006
