Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Successful Treatment of Severe Newly Diagnosed Immune Thrombocytopenia Involving an Alveolar Hemorrhage with Combination Therapy Consisting of Romiplostim, Rituximab and Vincristine
Kiyoshi OkazukaMasayoshi MasukoYuji MatsuoShukuko MiyakoshiTomoyuki TanakaTakashi KozakaiHironori KobayashiKyoko FuseYasuhiko ShibasakiMasato MoriyamaJun TakizawaIchiro FuseKen TobaTatsuo Furukawa
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2013 Volume 52 Issue 11 Pages 1239-1242


A 51-year-old man was admitted due to a severe bleeding tendency. After he was diagnosed with immune thrombocytopenia (ITP), several therapies, including steroids, steroid pulse, vincristine and rituximab, were administered; however, the patient's bleeding symptoms were not sufficiently controllable with these treatments. Subsequently, a diffuse alveolar hemorrhage was observed. Treatment with a thrombopoietin receptor agonist, romiplostim, was initiated to prevent lethal hemorrhaging, although the efficacy of thrombopoietic receptor agonists in such emergency situations has not been elucidated. The initiation of romiplostim achieved prompt remission in platelets. This case suggests that combination therapy with romiplostim, rituximab and vincristine is effective in cases of newly diagnosed severe therapy-resistant ITP.

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© 2013 by The Japanese Society of Internal Medicine
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