Abstract
Case 1 : A 50-year-old female was found to have advanced transverse colon cancer with simultaneous multiple liver metastases (SE N2 H2 P1 M1). She was started on treatment with mFOLFOX6 (oxaliplatin 75mg/m2, a bolus of 5-FU 400mg and 46-hour continuous intravenous infusion 2,000mg/m2). She was admitted for the 16th course of chemotherapy. Seven hours after the beginning of chemotherapy, she developed purpura and gingivorrhagia. A blood test revealed the platelet count to be 0.5 × 104/μl. She was treated with platelet transfusions and steroids. After 4 days, blood tests had normalized and she was discharged. Platelet associated IgG (PAIgG) was high(272 ng/107 cells) and, on the drug lymphocyte stimulation test(DLST), oxaliplatin was positive. We diagnosed drug-induced thrombocytopenia resulting from sensitivity to oxaliplatin. Case 2 : A 48-year-old male was found to have advanced rectal cancer with multiple liver and lung metastases (A N2 H3 PX M1). He was started on treatment with mFOLFOX6, as in case 1. He was admitted for the 21st course of chemotherapy. Seven hours after the beginning of chemotherapy, he developed purpura. A blood test revealed a platelet count of 0.1 × 104/μl. He was treated with platelet transfusions and steroids. After 6 days, blood tests had normalized and he was discharged.
