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CASE REPORT
Year : 2019  |  Volume : 13  |  Issue : 3  |  Page : 228-230

Renal transplant in a patient with idiopathic thrombocytopenic purpura refractory to steroid and intravenous immunoglobulin


1 Department of Medicine, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
2 Department of Nephrology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India

Correspondence Address:
Dr. Vinay Rathore
Department of Nephrology, Sawai Man Singh Medical College, Jaipur - 302 004, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijot.ijot_11_19

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Chronic kidney disease in immune thrombocytopenia (ITP) is uncommon, and renal transplant in this setting is especially rare. We present a case of successful renal transplantation in a patient with chronic ITP refractory to steroid and intravenous immunoglobulin (IVIg). A 27-year-old female suffering from ITP was referred to our center for renal transplant with her mother as a donor. Her platelets count failed to improve despite treatment with prednisolone (1 mg/kg/day for 4 weeks) and IVIg (1 g/kg/day for 2 consecutive days). She was then treated with eltrombopag (50 mg/day), a thrombopoietin receptor agonist, following which her platelet counts improved and allowed kidney transplantation to be performed safely. At 1 year of follow-up, her graft was functioning normally. The case report highlights that renal transplantation is feasible in patients with ITP, even if the disease is refractory to first-line agents. Eltrombopag may be used to increase the platelet count and decrease the risk of bleeding during the peritransplant period.


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