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. 2025 May 5;8(4):365-368.
doi: 10.1002/iju5.70041. eCollection 2025 Jul.

Leuprorelin-Induced Thrombocytopenia Successfully Treated With Surgical Resection of the Injection Site

Ryota Mori  1 , Satoru Taguchi  1 , Masahiro Yamamoto  1 , Yuta Inoue  1 , Koichiro Kanazawa  1 , Yoichi Fujii  1 , Haesu Lee  2 , Kiichi Furuse  2 , Hiroaki Maki  3 , Jun Kamei  1 , Shigenori Kakutani  1 , Yuta Yamada  1 , Aya Niimi  1 , Daisuke Yamada  1 , Aya Shinozaki-Ushiku  4 , Tetsuo Ushiku  4 , Mineo Kurokawa  3 , Mutsumi Okazaki  2 , Haruki Kume  1
Affiliations

Leuprorelin-Induced Thrombocytopenia Successfully Treated With Surgical Resection of the Injection Site

Ryota Mori et al. IJU Case Rep. .

Abstract

Introduction: Drug-induced thrombocytopenia (DITP) can be caused by many kinds of drugs. Its treatment generally involves discontinuation of the responsible drug.

Case presentation: A 70-year-old man received a subcutaneous injection of long-acting (24-week) leuprorelin depot as androgen deprivation therapy for prostate cancer. Four days after the injection, he presented with gingival bleeding and his platelet count was remarkably decreased (< 1000/μL). There was no sign of malignancy but the presence of megakaryocytes on bone-marrow examinations. Considering immune and/or DITP, he started immunoglobulin and steroid therapy while stopping all suspected medications. However, even a month later, his platelet count did not recover with the need for frequent platelet transfusions. Therefore, he eventually underwent surgical resection of the leuprorelin injection site. After the surgery, his platelet count drastically recovered and platelet transfusion became unnecessary.

Conclusion: We report a case of leuprorelin-induced thrombocytopenia that was successfully treated with surgical resection of the injection site.

Keywords: androgen deprivation therapy; drug‐induced thrombocytopenia; gonadotropin‐releasing hormone analog; leuprorelin; prostate cancer.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(A) Preoperative computed tomography identified the leuprorelin injection site as increased adipose tissue density (arrow, 30 × 15 mm). (B) The leuprorelin injection site was also palpable as subcutaneous induration. (The red dashed line shows the planned area for resection, while the red solid line indicates the planned line for skin incision.) (C) The subcutaneous adipose tissue of the leuprorelin injection site was completely excised with a sufficient surgical margin until the anterior rectus sheath was exposed (45 × 30 mm). (D) Macroscopic image of the excised subcutaneous tissue. (E) Microscopic image of the specimen (hematoxylin and eosin stain) showed fibrosis admixed with degenerated adipose cells and histiocytes with foreign material.
FIGURE 2
FIGURE 2
Clinical course including changes in platelet count and doses of prednisolone.
See this image and copyright information in PMC

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