Evolocumab-induced severe thrombocytopenia
10.3760/cma.j.cn114015-20240509-00321
- VernacularTitle:依洛尤单抗致严重血小板减少症
- Author:
Yajun XIE
1
;
Bei ZHAO
;
Shixing LI
;
Xiaoye LI
;
Ning SHI
Author Information
1. 战略支援部队特色医学中心药剂科，北京 100101
- Publication Type:Journal Article
- Keywords:
Purpura, thrombocytopenic, idiopathic;
Hypolipidemic agents;
Cardiovascular diseases;
Evolocumab
- From:
Adverse Drug Reactions Journal
2024;26(9):574-576
- CountryChina
- Language:Chinese
-
Abstract:
A 61-year-old male patient with coronary heart disease was treated with dual antiplatelet therapy, lipid-lowering therapy (atorvastatin) and other symptomatic drugs after coronary interventions. Because the patient was at ultra-high-risk of cardiovascular events, had multiple in-stent restenosis, and had uncontrolled blood lipids, subcutaneous injection of evolocumab 140 mg was added once every 2 weeks. The platelet count (PLT) of the patient was within the reference range before evolocumab application. After 2 injections of evolocumab, he developed bloody sputum, blood blisters on the lips and scattered bleeding points around the body, with PLT 19×10 9/L. The dual antiplatelet therapy and evolocumab were suspended, but the bleeding was aggravated. According to the results of bone marrow puncture and biopsy, the patient was diagnosed with idiopathic thrombocytopenic purpura. Glucocorticoid, human immunoglobulin, recombinant human thrombopoietin and platelet transfusion were given but not effective. Subsequently, herombopag was added and PLT gradually increased. After 25 days, the PLT was 109×10 9/L.
