Drug-induced Thrombotic Thrombocytopenic Purpura Successfully Treated with Recombinant Human Soluble Thrombomodulin

  • Nishijima Yu
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan Postgraduate Medical Training Center, Osaka University Hospital, Japan
  • Hirata Haruhiko
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Himeno Aiko
    Postgraduate Medical Training Center, Osaka University Hospital, Japan
  • Kida Hiroshi
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Matsumoto Masanori
    Department of Blood Transfusion Medicine, Nara Medical University, Japan
  • Takahashi Ryo
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Otani Yasushi
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Inoue Kouji
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Nagatomo Izumi
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Takeda Yoshito
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Kijima Takashi
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Tachibana Isao
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan
  • Fujimura Yoshihiro
    Department of Blood Transfusion Medicine, Nara Medical University, Japan
  • Kumanogoh Atsushi
    Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Japan

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Abstract

A 61-year-old woman with recurrent non-small cell lung cancer presented with thrombocytopenia, microangiopathic hemolytic anemia, neurological abnormalities, renal failure and a fever that appeared during chemotherapy with gemcitabine and bevacizumab. She was diagnosed with drug-induced thrombotic thrombocytopenic purpura (TTP). After the discontinuation of chemotherapy, the administration of recombinant human soluble thrombomodulin and fresh-frozen plasma rapidly ameliorated the TTP. Hypertension preceded the onset of TTP and required the administration of quadruple therapy on admission. However, after three months, the hypertension was controllable without anti-hypertensive drugs. Twelve months later, the ninth course of vinorelbine was administered safely, preventing the patient's lung cancer from progressing.<br>

Journal

  • Internal Medicine

    Internal Medicine 52 (10), 1111-1114, 2013

    The Japanese Society of Internal Medicine

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