A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab

A 72-year-old man with a 10-year history of coronary heart disease started evolocumab treatment once a month after developing excess myalgia due to therapy with a 3-hydroxy-methylglutaryl CoA reductase inhibitor. No side effects such as myalgia symptoms had been reported during the first 14 months o...

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Main Authors: Ikuo Inoue, Yasuhiro Takenaka, Yoshitora Kin, Satoshi Yamazaki, Yuichi Ikegami, Daigo Saito, Akira Shimada
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2020/3281626
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author Ikuo Inoue
Yasuhiro Takenaka
Yoshitora Kin
Satoshi Yamazaki
Yuichi Ikegami
Daigo Saito
Akira Shimada
author_facet Ikuo Inoue
Yasuhiro Takenaka
Yoshitora Kin
Satoshi Yamazaki
Yuichi Ikegami
Daigo Saito
Akira Shimada
author_sort Ikuo Inoue
collection DOAJ
description A 72-year-old man with a 10-year history of coronary heart disease started evolocumab treatment once a month after developing excess myalgia due to therapy with a 3-hydroxy-methylglutaryl CoA reductase inhibitor. No side effects such as myalgia symptoms had been reported during the first 14 months of evolocumab treatment; however, he suddenly presented with acute severe thrombocytopenia following the 14th treatment. His platelet count continued to decrease to a nadir of 1,000/μL. His platelet-associated immunoglobulin G level had elevated to 790 ng/107 cells. He started receiving a combination of steroid therapy, high-dose immunoglobulin therapy, and platelet transfusions, but the first-line therapy was ineffective. He was subsequently treated with a thrombopoietin receptor agonist, and his platelet count recovered to 250,000/μL.
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issn 2090-6560
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language English
publishDate 2020-01-01
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record_format Article
series Case Reports in Hematology
spelling doaj-art-cb300bb50d404fc2bf5e6b4e2a5e15332025-08-20T03:19:29ZengWileyCase Reports in Hematology2090-65602090-65792020-01-01202010.1155/2020/32816263281626A Sudden Onset of Severe Thrombocytopenia While Using EvolocumabIkuo Inoue0Yasuhiro Takenaka1Yoshitora Kin2Satoshi Yamazaki3Yuichi Ikegami4Daigo Saito5Akira Shimada6Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, JapanDepartment of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, JapanDepartment of Internal Medicine, Fukaya Red Cross Hospital, 5-8-1 Kamishibatyohnishi, Fukaya, Saitama 366-0052, JapanKumagaya-geka Hospital, 3811-1 Sayata, Kumagaya, Saitama 360-0023, JapanDepartment of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, JapanDepartment of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, JapanDepartment of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama 350-0495, JapanA 72-year-old man with a 10-year history of coronary heart disease started evolocumab treatment once a month after developing excess myalgia due to therapy with a 3-hydroxy-methylglutaryl CoA reductase inhibitor. No side effects such as myalgia symptoms had been reported during the first 14 months of evolocumab treatment; however, he suddenly presented with acute severe thrombocytopenia following the 14th treatment. His platelet count continued to decrease to a nadir of 1,000/μL. His platelet-associated immunoglobulin G level had elevated to 790 ng/107 cells. He started receiving a combination of steroid therapy, high-dose immunoglobulin therapy, and platelet transfusions, but the first-line therapy was ineffective. He was subsequently treated with a thrombopoietin receptor agonist, and his platelet count recovered to 250,000/μL.http://dx.doi.org/10.1155/2020/3281626
spellingShingle Ikuo Inoue
Yasuhiro Takenaka
Yoshitora Kin
Satoshi Yamazaki
Yuichi Ikegami
Daigo Saito
Akira Shimada
A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab
Case Reports in Hematology
title A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab
title_full A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab
title_fullStr A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab
title_full_unstemmed A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab
title_short A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab
title_sort sudden onset of severe thrombocytopenia while using evolocumab
url http://dx.doi.org/10.1155/2020/3281626
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