Refractory Thrombocytopenia Responds to Octreotide Treatment in a Case of Evans Syndrome with Gastric Neuroendocrine Tumor. (31st July 2013)

• Record Type: Journal Article
• Authors: Chung-Delgado, Kocfa; Revilla-Montag, Alejandro; Guillén-Bravo, Sonia; Ríos-Díaz, Hugo; Alva-Muñoz, José C.
• Other Names: Aref S. Academic Editor.; Imai C. Academic Editor.; Sonoki T. Academic Editor.
• Is Part Of: Case reports in hematology. Volume 2013(2013)
• Publication Date: 2013-07-31
• Subjects: Hematology -- Periodicals; Hematology -- Case studies -- Periodicals; Blood -- Diseases -- Periodicals; Hematology; Hematologic Diseases; Blood -- Diseases; Hematology; Electronic journals; Periodicals; Case studies; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.15
• DOI: 10.1155/2013/391086
• Languages: English
• ISSNs: 2090-6560

Abstract

Abstract : A 37-year-old woman with history of Evans Syndrome with poor response to high-dose corticoid treatment presented to the emergency department with gastrointestinal and vaginal bleeding. The patient was later diagnosed with severe thrombocytopenia and a stage G1, well-differentiated gastric neuroendocrine tumor, confirmed by a biopsy. A total gastrectomy was performed to eradicate the tumor. After being treated with a total splenectomy for her Evans Syndrome with no clinical or laboratory improvement, she began regular treatment with octreotide on the basis of a possible hepatic metastasis. Days after the initiation of the octreotide, an increase in the platelet count was evidenced by laboratory findings, from 2, 000 platelets/mm 3 to 109, 000 platelets/mm 3 . Weeks later, the hepatic metastasis is discarded by a negative octreotide-body scan, and the octreotide treatment was interrupted. Immediately after the drug interruption, a progressive and evident descent in the platelet count was evidenced (4000 platelets/mm 3 ). The present case report highlights the possible association between octreotide treatment and a severe thrombocytopenia resistant to conventional treatment.