Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Case Report Volume 6 Issue 4

Use of Eltrombopag Among Patients with Liver Cirrhosis: A Case Series

Jose Orlando Nicolas MD and Ira Inductivo-Yu MD*

Division of Internal Medicine, National Kidney and Transplant Institute, Manila, Philippines

*Corresponding Author: Ira Inductivo-Yu MD, Division of Internal Medicine, National Kidney and Transplant Institute, Manila, Philippines.

Received: March 16, 2023; Published: March 20, 2023

Abstract

Background: Thrombocytopenia is commonly found among patients with liver cirrhosis. It complicates treatment of patients requiring an invasive procedure as part of their routine clinical care. An important clinical question is whether there is a need for a platelet-stimulating growth factor or thrombopoietin receptor agonist among patients with liver cirrhosis who have thrombocytopenia.

Case Summary: This paper discusses the profile of three patients with thrombocytopenia and liver cirrhosis who received Eltrombopag prior to invasive procedures and one patient in the control of hemorrhagic stroke expansion. Eltrombopag was given at doses of 25 mg to 50 mg daily for two to three weeks, except one patient who was maintained for more than a year. Bleeding complications were prevented in all patients, with no adverse events seen during and post treatment.

Conclusion: Treatment with eltrombopag is an effective and safe approach to increase platelet counts in thrombocytopenic cirrhotic patients

Keywords: Case Series; Eltrombopag; Liver Cirrhosis; Thrombocytopenia; Platelet Transfusion

References

  1. Peck-Radosavljevic M. “Thrombocytopenia in chronic liver disease”. Liver International : Official Journal of the International Association for the Study of the Liver6 (2017): 778-793.
  2. Hanny Al-Samkari and David J Kuter. “Antiplatelet Antibody Testing in Immune Thrombocytopenia and Evans Syndrome: Longitudinal Serologic Evolution and Relation to Clinical Features”. Blood 132 (2018):
  3. Hepatitis data and statistics in the Western Pacific. World Health Organization (2022).
  4. Asrani S K., et al. “Burden of liver diseases in the world”. Journal of Hepatology1 (20192:) 151-171.
  5. Poelstra K and Schuppan D. “Targeted therapy of liver fibrosis/cirrhosis and its complications”. Journal of Hepatology3 (2011): 726-728.
  6. Hayashi H., et al. “Management of thrombocytopenia due to liver cirrhosis: a review”. World Journal of Gastroenterology10 (2014): 2595-2605.
  7. Afdhal NH., et al. “Eltrombopag before procedures in patients with cirrhosis and thrombocytopenia”. The New England Journal of Medicine8 (2012): 716-724.
  8. Sigal Samuel., et al. “The pathophysiology of thrombocytopenia in chronic liver disease”. Hepatic Medicine: Evidence and Research 8 (2016):
  9. Jelkmann W. “The role of the liver in the production of thrombopoietin compared with erythropoietin”. European Journal of Gastroenterology and Hepatology7 (2001): 791-801.
  10. Mohamed Sabah and Yassin Mohamed. “Eltrombopag Use for Treatment of Thrombocytopenia in a Patient with Chronic Liver Disease and Portal Vein Thrombosis: Case Report”. Case Reports in Oncology (2020):
  11. Tse Wei Chen., et al. “Refractory Coronary Stent Thrombosis in a Patient with Chronic Immune Thrombocytopenia on Eltrombopag”. Acta Cardiologica Sinica5 (2021): 542-545.
  12. Raymond SM., et al. “Safety and efficacy of long-term treatment of chronic/persistent ITP with eltrombopag: final results of the EXTEND study". Blood23 (2017): 2527.
  13. James Bussel., et al. “Repeated short-term use of eltrombopag in patients with chronic immune thrombocytopenia (ITP)”. British Journal of Hematology 160 (2013): 538-546.
  14. Gregory Cheng., et al. “Eltrombopag for management of chronic immune thrombocytopenia (RAISE): a 6-month, randomised, phase 3 study”. The Lancet9763 (2011): 393-402201.

Citation

Citation: Jose Orlando Nicolas MD and Ira Inductivo-Yu MD. “Splenic Artery Aneurysm. A Rare Entity Case Report". Acta Scientific Gastrointestinal Disorders 6.4 (2023): 18-22.

Copyright

Copyright: © 2023 Jose Orlando Nicolas MD and Ira Inductivo-Yu MD. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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