LaMoreaux Brian, Barbar-Smiley Fatima, Ardoin Stacy, Madhoun Hareth
Department of Rheumatology, Ohio State Wexner Medical Center, 543 Taylor Ave, Columbus, OH 43210.
Section of Pediatric Rheumatology, Nationwide Children׳s Hospital, Columbus, OH.
Semin Arthritis Rheum. 2016 Feb;45(4):e10-2. doi: 10.1016/j.semarthrit.2015.07.008. Epub 2015 Jul 29.
Romiplostim is a thrombopeitin-receptor agonist approved for raising platelet counts in patients with immune thrombocytopenia (ITP). Several hematologic adverse effects have been reported including acute myeloid leukemia, myelofibrosis, and thrombosis.
We report two cases, one pediatric and one adult patient, who had antiphospholipid antibodies and received romiplostim for ITP. Additionally, we conducted medline, Food and Drug Administration (FDA) Adverse Events reports website, and manufacturer's adverse events database.
Both patients developed thrombosis with evidence for catastrophic antiphospholipid syndrome (CAPS) after treatment with romiplostim. No reports or events were found from literature and database searches in regards to thrombosis associated with romiplostim in patients with antiphospholipid syndrome.
These cases illustrate the potential for thrombosis with the administration of romiplostim. The administration of this drug to patients with a history of an autoimmune disease, especially those with positive antiphospholipid antibodies, should be done with caution.
罗米司亭是一种血小板生成素受体激动剂，已被批准用于提高免疫性血小板减少症（ITP）患者的血小板计数。已报告了几种血液学不良反应，包括急性髓系白血病、骨髓纤维化和血栓形成。
我们报告了两例病例，一例儿科患者和一例成年患者，他们患有抗磷脂抗体，并接受罗米司亭治疗ITP。此外，我们检索了医学文献数据库、美国食品药品监督管理局（FDA）不良事件报告网站以及制造商的不良事件数据库。
两名患者在接受罗米司亭治疗后均发生血栓形成，并伴有灾难性抗磷脂综合征（CAPS）的证据。在文献和数据库检索中，未发现关于抗磷脂综合征患者使用罗米司亭相关血栓形成的报告或事件。
这些病例说明了使用罗米司亭可能导致血栓形成。对于有自身免疫性疾病史的患者，尤其是抗磷脂抗体阳性的患者，使用这种药物时应谨慎。
