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Case Reports
. 2020;59(20):2571-2575.
doi: 10.2169/internalmedicine.4785-20. Epub 2020 Oct 15.

Thrombocytopenia Caused by Dexamethasone in a Patient with Colorectal Cancer

Ryosuke Taguchi  1 , Kenji Tsuchihashi  1 , Yuta Okumura  1 , Michitaka Nakano  1 , Tomoyasu Yoshihiro  2 , Hirofumi Ohmura  2 , Nobuhiro Tsuruta  2 , Fumiyasu Hanamura  2 , Kyoko Yamaguchi  2 , Mamoru Ito  2 , Hiroshi Ariyama  1 , Hitoshi Kusaba  1 , Koichi Akashi  2 , Eishi Baba  3
Affiliations
Case Reports

Thrombocytopenia Caused by Dexamethasone in a Patient with Colorectal Cancer

Ryosuke Taguchi et al. Intern Med. 2020.

Abstract

Drug-induced immune thrombocytopenia (DITP) is an important cause of thrombocytopenia. A 73-year-old man with relapsed rectal carcinoma received S-1, oxaliplatin and bevacizumab combination therapy (SOX+Bev). Dexamethasone was administered as an antiemetic prophylaxis. On day 2 of the first cycle, thrombocytopenia (8,000/μL) was observed. We sequentially omitted any drugs suspected to possibly induce thrombocytopenia and confirmed dexamethasone as the cause of thrombocytopenia. DITP induced by synthetic corticosteroids is very rare and this is the first case report of DITP induced by dexamethasone. Although rare, DITP due to synthetic corticosteroids including dexamethasone should be a differential diagnosis among patients receiving synthetic corticosteroids with thrombocytopenia.

Keywords: dexamethasone; drug-induced immune thrombocytopenia.

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Conflict of interest statement

Author's disclosure of potential Conflicts of Interest (COI).

Koichi Akashi: Honoraria, Astellas Pharma, AbbVie, Eisai, Kyowa Kirin, Novartis Pharma, Bristol-Myers Squibb, Celgene, Janssen Pharmaceutical, Takeda Pharmaceutical, Chugai Pharmaceutical, Otsuka Pharmaceutical, Daiichi Sankyo, Amgen Astellas BioPharma and Ono Pharmaceutical; Research funding, Kyowa Kirin, Shino-Test, Canon Medical Systems, Astellas Pharma, Otsuka Pharmaceutical, Janssen Pharmaceutical, Bristol-Myers Squibb and Chugai Pharmaceutical. Eishi Baba: Honoraria, Eli Lilly Japan.

Figures

Figure.
Figure.
The time course of platelet count. Upper boxes show administrated drugs. OHP: oxaliplatin, Bev: bevacizumab, DEX: dexamethasone (Dexart®), Palo: palonosetron, Plt: platelet transfusion
See this image and copyright information in PMC

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