Severe Late-Onset Drug-Induced Immune Thrombocytopenia Following IFN β-1a Treatment: A Case Report of a 52-Year-Old Woman with Relapse-Remitting Multiple Sclerosis

Christophe Cisarovsky; Marie Théaudin; Pierre-Alexandre Bart; Grégoire Stalder; Lorenzo Alberio

doi:10.1155/2022/2767031

Severe Late-Onset Drug-Induced Immune Thrombocytopenia Following IFN β-1a Treatment: A Case Report of a 52-Year-Old Woman with Relapse-Remitting Multiple Sclerosis

Case Rep Hematol. 2022 Nov 24:2022:2767031. doi: 10.1155/2022/2767031. eCollection 2022.

Authors

Christophe Cisarovsky¹, Marie Théaudin², Pierre-Alexandre Bart¹, Grégoire Stalder³, Lorenzo Alberio³

Affiliations

¹ Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
² Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
³ Service and Central Laboratory of Hematology, Department of Oncology and Department, Laboratories and Pathology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.

Abstract

Interferon β-1a (IFNβ1a) is considered safe in relapsing-remitting multiple sclerosis (RRMS). Drug-induced thrombocytopenia (DITP) is a rare but underreported adverse event that is often confused with other causes of thrombocytopenia. We report the case of a 52-year-old woman who developed limb and oral mucosa petechiae and hematochezia, 10 years after beginning IFNβ1a. Blood work showed an isolated severe thrombocytopenia and ruled out other autoimmune diseases, viral infections, intravascular hemolysis, and renal impairment. Oral corticosteroids and tranexamic acid were initiated with a favorable platelet response. IFNβ1a was resumed, leading to recurrence of thrombocytopenia. Platelets came back to normal after intravenous immunoglobulins and IFNβ1a was definitively discontinued. To our knowledge, this is the first case of drug-induced immune thrombocytopenia (DITP) associated with IFNβ1a.

Publication types

Case Reports