特発性血小板減少性紫斑病による口腔内出血に対してエルトロンボパグを投与した1例

• Published in: 日本口腔外科学会雑誌 Vol. 67; no. 11; pp. 649 - 654
• Main Authors: 山本, 大介, 目瀬, 浩, 高倉, 裕明
• Format: Journal Article
• Language: Japanese
• Published: 公益社団法人 日本口腔外科学会 20.11.2021
• Subjects: エルトロンボパグ; トロンボポエチン受容体作動薬; 口腔内出血; 特発性血小板減少性紫斑病
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.67.649

Eltrombopag is the world’s first orally administrable hematopoietic factor preparation, and has been covered by insurance since 2011. We report a case of idiopathic thrombocytopenic purpura (ITP) in which eltrombopag was administered to control oral bleeding. The patient was an 81-year-old woman. Her medical history included gastric ulcer and post helicobacter pylori eradication therapy. In March 2018, she visited our department with the chief complaint of persistent bleeding from the left buccal mucosa. At the first visit, a hematoma and slight persistent bleeding were observed in the left buccal mucosa in the oral cavity. The patient visited our hospital’s hematology department because her blood test for suspected bleeding diathesis revealed a markedly low platelet count of 0.2 × 104/μ L. As a result, ITP was diagnosed. Steroid therapy was started at our hospital, denture use was discontinued, and local hemostasis was continued. Oral administration of eltrombopag was started on the 2nd day of illness, and 10 units of concentrated platelets were administered on the 3rd day of illness. Complete hemostasis was achieved on the 5th day of illness. After that, the patient was discharged without rebleeding, since the platelet count had recovered to 3.2×104/μ L on the 17th hospital day.