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Case Report

Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report

by
Eman Mostafa Hamed
1,*,
Mohamed Hussein Meabed
2,
Ahmed R. N. Ibrahim
3,*,
Ahmed M. Khalaf
4,
Doaa Mohamed El Demerdash
5,
Marwa O. Elgendy
1,6,
Haitham Saeed
7,
Tamer M. Mahmoud
8,
Heba F. Salem
9,10 and
Hoda Rabea
7
1
Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62521, Egypt
2
Department of Pediatrics and Hematology, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt
3
Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia
4
Department of Internal Medicine and Clinical Hematology, Beni-Suef University, Beni-Suef 62521, Egypt
5
Department of Internal Medicine and Clinical Hematology, Faculty of Medicine, Cairo University, Giza 54212, Egypt
6
Department of Clinical Pharmacy, Faculty of Medicine, Beni-Suef University Hospitals, Beni-Suef University, Beni-Suef 62521, Egypt
7
Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62521, Egypt
8
Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt
9
Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62521, Egypt
10
Pharmaceutics and Industrial Pharmacy Department, 6 October Technological University, Giza 62521, Egypt
*
Authors to whom correspondence should be addressed.
Medicina 2023, 59(9), 1645; https://doi.org/10.3390/medicina59091645
Submission received: 4 August 2023 / Revised: 1 September 2023 / Accepted: 7 September 2023 / Published: 11 September 2023
(This article belongs to the Special Issue Advances in the Pathogenesis and Treatment of Inflammatory Immune Diseases)
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Abstract

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by antigen-specific T cells and antiplatelet autoantibodies that inhibit platelet production in the bone marrow or destroy platelets in the spleen. ITP is a form of autoimmunity and is closely associated with inflammation. Corticosteroids are the first-line therapy for ITP, with a total response rate of 53–80%. However, corticosteroid therapy is associated with significant side effects and is often ineffective in patients with corticosteroid-resistant or -intolerant disease. Eltrombopag has been validated as a second-line option in ITP therapy. Despite several studies demonstrating the efficacy and safety of Eltrombopag in immune thrombocytopenia patients, the prevalence of Eltrombopag-induced acute kidney injury has been observed. This case report describes a patient who experienced acute kidney injury during Eltrombopag therapy. A sudden increase in serum creatinine to 6.7 mg/dL and metabolic acidosis occurred after eight weeks of Eltrombopag. The patient’s renal failure had worsened, proteinuria was detected, and emergency hemodialysis was initiated. With vigilant kidney function screening and prompt treatment, the patient’s renal function improved remarkably following cessation of Eltrombopag and initiation of hemodialysis. This case highlights the importance of comprehensive medication history-taking and vigilant kidney function screening in patients receiving Eltrombopag.
Keywords: autoimmune disease; immune thrombocytopenia; relapsed; acute kidney injury; drug induced; Eltrombopag; corticosteroid resistance autoimmune disease; immune thrombocytopenia; relapsed; acute kidney injury; drug induced; Eltrombopag; corticosteroid resistance

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MDPI and ACS Style

Hamed, E.M.; Meabed, M.H.; Ibrahim, A.R.N.; Khalaf, A.M.; El Demerdash, D.M.; Elgendy, M.O.; Saeed, H.; Mahmoud, T.M.; Salem, H.F.; Rabea, H. Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report. Medicina 2023, 59, 1645. https://doi.org/10.3390/medicina59091645

AMA Style

Hamed EM, Meabed MH, Ibrahim ARN, Khalaf AM, El Demerdash DM, Elgendy MO, Saeed H, Mahmoud TM, Salem HF, Rabea H. Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report. Medicina. 2023; 59(9):1645. https://doi.org/10.3390/medicina59091645

Chicago/Turabian Style

Hamed, Eman Mostafa, Mohamed Hussein Meabed, Ahmed R. N. Ibrahim, Ahmed M. Khalaf, Doaa Mohamed El Demerdash, Marwa O. Elgendy, Haitham Saeed, Tamer M. Mahmoud, Heba F. Salem, and Hoda Rabea. 2023. "Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report" Medicina 59, no. 9: 1645. https://doi.org/10.3390/medicina59091645

APA Style

Hamed, E. M., Meabed, M. H., Ibrahim, A. R. N., Khalaf, A. M., El Demerdash, D. M., Elgendy, M. O., Saeed, H., Mahmoud, T. M., Salem, H. F., & Rabea, H. (2023). Clinical Care Team’s Guide for Awareness on Risk Assessment of Eltrombopag Complicating Acute Kidney Injury in Relapsed Immune Thrombocytopenic Patients: A Case Report. Medicina, 59(9), 1645. https://doi.org/10.3390/medicina59091645

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