Fecha de recepción: 21/12/2017 – Fecha de aceptación: 05/03/2018
Martín Blas C1, Díez Fernández R1, Chica Gullón E2, Sánchez-Rubio Ferrández J1
1 Servicio de Farmacia
2 Servicio de Hematología
Hospital Universitario de Getafe. Madrid (España)
____
Correspondencia:
Cristina Martín Blas
Hospital Universitario de Getafe
(Servicio de Farmacia)
Ctra. Toledo Km. 12,500 s/n
28905 Getafe (Madrid)
Correo electrónico: cmblas@salud.madrid.org
____
SUMMARY
Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by platelet destruction and abnormal thrombopoiesis, associated with the presence of autoantibodies that desializes GP Ib/IX and/or GP IIb/IIIa surface glycoproteins. Oseltamivir acts as a selective inhibitor of sialidases and this makes it may have a role in these patients. We report a case of a 68-year-old woman, with chronic psoriasis and ITP refractory to corticosteroids, intravenous immunoglobulin, rituximab, splenectomy, and thrombopoietin receptor analogues (TPO-RA) in monotherapy and combination therapy, in which oseltamivir (75 mg every 12 hours for 4 weeks), in combination with romiplostim and intermediate doses of corticosteroids, achieved a maintained response in normal platelet count range for 42 days (a maximum of 184×103/μL platelets). A second course of oseltamivir during 3 weeks did not work. The patient platelet count study showed only a slight improvement in sialic acid loss after 14 days of treatment with oseltamivir. Furthermore, patient serum did not produce desialization of control platelets, which may suggest that there were not platelet surface anti-GPIb/IX antibodies in this patient, and may indicate that oseltamivir is not a valid therapy for these profile patients.
Key Words: Oseltamivir, immune thrombocytopenic purpura, sialidase.
____
Descargar artículo en PDF: Oseltamivir en paciente con trombocitopenia primaria inmune refractaria