Romiplostim as early treatment of immune thrombocytopenia with severe immunodeficiency

Abstract

Immunosuppressive agents are the standard therapeutic approach for immune thrombocy-topenia (ITP). Their prolonged use may increase the risk of infectious complications, particularly when the patient is already at higher infectious risk. In this setting, the use of drugs with a mechanism of action alterna-tive to immunosuppression, like thrombopoi-etin receptor agonists (TRAs), may find partic-ular indication. We report the unique case of a patient with severe immunodeficiency and ITP, who experienced a serious infectious compli-cation while on steroids treatment, and who was successfully treated with Romiplostim sec-ond-line. The present experience supports the effectiveness and safety of TRAs as early treatment of ITP patients with drug-induced immunodeficiency or with active infections.