Dural Venous Sinus Thrombosis and Pulmonary Embolism Following Immunoglobulin Treatment in Pediatric Patient With Immune Thrombocytopenic Purpura

J Pediatr Hematol Oncol. 2017 Nov;39(8):e508-e511. doi: 10.1097/MPH.0000000000000841.

Abstract

Intravenous immunoglobulin (IVIG) is a widely used agent as the first choice of treatment of immune thrombocytopenic purpura (ITP). IVIG has several side effects, but it is a relatively safe treatment. Life-threatening thrombosis has been reported in adults and rarely in children. We report a case of a 14-year-old boy with dural venous sinus thrombosis and pulmonary embolism after treatment with IVIG for ITP. The patient was treated with low-molecular-weight heparin followed by warfarin and the symptoms were recovered. If a patient with ITP shows mental change or respiratory difficulty, we should consider thrombosis as well as hemorrhage.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anticoagulants / therapeutic use
  • Biopsy
  • Bone Marrow / pathology
  • Hematologic Tests
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Magnetic Resonance Angiography
  • Male
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology*
  • Purpura, Thrombocytopenic, Idiopathic / complications*
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic / therapy
  • Sinus Thrombosis, Intracranial / diagnosis*
  • Sinus Thrombosis, Intracranial / drug therapy
  • Sinus Thrombosis, Intracranial / etiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / etiology
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Immunoglobulins, Intravenous
  • Warfarin