Abstract
An oral thrombopoietin-receptor agonist (eltrombopag) is now available for use in patients with refractory chronic idiopathic thrombocytopenic purpura (ITP), but the risk of liver dysfunction was found to be increased in those receiving eltrombopag. Thus, careful administration is required for patients with liver dysfunction, including better identification of the causes of liver damage. We herein report a patient with refractory chronic ITP who had received numerous blood transfusions since the 1960s and had suffered chronic active hepatitis as a result of hepatitis C virus (HCV) infection. Eltrombopag increased her platelet counts, with subsequent improvement of liver function, and allowed interferon therapy to be initiated and continued without rescue platelet transfusion. Severe thrombocytopenia increases the risk of bleeding during interferon therapy and often results in postponement, or even suspension, of serial administrations. Using a thrombopoietin-receptor agonist in accordance with strict treatment indications and careful observation may allow interferon therapy to be performed safely for some patients with complex disorders similar to those of our patient.
