Portal vein thrombosis as complication of romiplostim treatment in a cirrhotic patient with hepatitis C-associated immune thrombocytopenic purpura.


BACKGROUND & AIMS:Thrombopoietin receptor agonists are a new class of compounds licenced for the treatment of immune thrombocytopenic purpura. They are currently being studied for patients with thrombopenia in advanced liver disease or under therapy for hepatitis C. There are indications that the risk for development of portal vein thrombosis in patients with advanced liver cirrhosis might be increased under therapy with thrombopoietin receptor agonists. We report a case of a patient with Child class B liver cirrhosis with concurrent immune thrombocytopenic purpura that developed portal vein thrombosis under therapy with the thrombopoietin receptor agonist romiplostim. METHODS:A 50-year-old woman with hepatitis C virus associated immune thrombocytopenic purpura and Child class B liver cirrhosis presented in our emergency with rapidly evolving hydropic decompensation and general malaise. For immune thrombocytopenic purpura, the patient was started on the thrombopoietin receptor agonist romiplostim nine months ago. RESULTS:During hospitalization, the platelet count was measured above 330,000/μl and partial portal vein thrombosis was diagnosed by imaging studies. The thrombotic event was assumed to be associated with the romiplostim treatment for immune thrombocytopenic purpura via excessive elevation of platelet count. After anticoagulation with heparin and cessation of romiplostim treatment, complete recanalisation of the portal vein was achieved. CONCLUSIONS:We conclude that romiplostim should be used with precaution in patients with hepatitis C-associated immune thrombocytopenic purpura and advanced liver cirrhosis as the risk for thrombotic complications may increase significantly.


J Hepatol


Journal of hepatology


Dultz G,Kronenberger B,Azizi A,Mihm U,Vogl TJ,Sarrazin U,Sarrazin C,Zeuzem S,Hofmann WP




Has Abstract


2011-07-01 00:00:00














  • Embolization of hepatocellular carcinoma with drug-eluting beads: doxorubicin tissue concentration and distribution in patient liver explants.

    abstract:BACKGROUND & AIMS:To follow the local tissue delivery of doxorubicin in HCC explants from patients embolized with drug-eluting beads and to compare it with histologic modifications. METHODS:Six patients with HCC underwent chemoembolization with doxorubicin-eluting beads (caliber 100-300 μm, dose 75-150 mg) followed by...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Namur J,Citron SJ,Sellers MT,Dupuis MH,Wassef M,Manfait M,Laurent A

    更新日期:2011-12-01 00:00:00

  • Mouse organic solute transporter alpha deficiency alters FGF15 expression and bile acid metabolism.

    abstract:BACKGROUND & AIMS:Blocking intestinal bile acid (BA) absorption by inhibiting or inactivating the apical sodium-dependent BA transporter (Asbt) classically induces hepatic BA synthesis. In contrast, blocking intestinal BA absorption by inactivating the basolateral BA transporter, organic solute transporter alpha-beta (...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Lan T,Rao A,Haywood J,Kock ND,Dawson PA

    更新日期:2012-08-01 00:00:00

  • SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19.

    abstract:Background & Aims:Liver enzyme abnormalities are common in patients with coronavirus disease 2019 (COVID-19). Whether or not severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to liver damage per se remains unknown. Herein, we reported the clinical characteristics and liver pathological man...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Wang Y,Liu S,Liu H,Li W,Lin F,Jiang L,Li X,Xu P,Zhang L,Zhao L,Cao Y,Kang J,Yang J,Li L,Liu X,Li Y,Nie R,Mu J,Lu F,Zhao S,Lu J,Zhao J

    更新日期:2020-10-01 00:00:00

  • Effects of ursodeoxycholic acid after 4 to 12 years of therapy in early and late stages of primary biliary cirrhosis.

    abstract::Twenty-two patients with primary biliary cirrhosis were treated with ursodeoxycholic acid, 10 mg/kg per day. Fourteen patients with stages I/II were treated for 4-12 years (mean 7.5), and eight patients with stages III/IV for 5-12 years (mean 6.5). Twelve of 13 patients with early stages became asymptomatic. Aminotran...

    journal_title:Journal of hepatology

    pub_type: 临床试验,杂志文章


    authors: Leuschner U,Güldütuna S,Imhof M,Hübner K,Benjaminov A,Leuschner M

    更新日期:1994-10-01 00:00:00

  • Differences and similarities in early atherosclerosis between patients with non-alcoholic steatohepatitis and chronic hepatitis B and C.

    abstract:BACKGROUND/AIMS:To compare carotid intima-media thickness (IMT) - an index of early atherosclerosis - among patients with non-alcoholic steatohepatitis (NASH), patients with chronic hepatitis B (HBV) or C (HCV) and control subjects. METHODS:We studied 60 consecutive patients with biopsy-proven NASH, 60 patients with H...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Targher G,Bertolini L,Padovani R,Rodella S,Arcaro G,Day C

    更新日期:2007-06-01 00:00:00

  • Norfloxacin primary prophylaxis of bacterial infections in cirrhotic patients with ascites: a double-blind randomized trial.

    abstract:BACKGROUND/AIMS:Norfloxacin is useful to prevent infections in hospitalized cirrhotic patients with low ascitic fluid protein concentrations. It is also effective in preventing the recurrence of spontaneous bacterial peritonitis. The aim of our study was to determine the efficacy of norfloxacin in the primary prophylax...

    journal_title:Journal of hepatology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Grangé JD,Roulot D,Pelletier G,Pariente EA,Denis J,Ink O,Blanc P,Richardet JP,Vinel JP,Delisle F,Fischer D,Flahault A,Amiot X

    更新日期:1998-09-01 00:00:00

  • Characterisation of citrate and iron citrate uptake by cultured rat hepatocytes.

    abstract:BACKGROUND/AIMS:The endogenous low molecular weight iron chelator, citrate, is considered to be an important contributor to iron transport and the liver the main site of uptake of iron citrate in subjects suffering from diseases of iron overload. Moreover, the citrate-metabolising enzyme, aconitase, is implicated in th...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:1998-10-01 00:00:00

  • CD4+ CXCR5+ T cells in chronic HCV infection produce less IL-21, yet are efficient at supporting B cell responses.

    abstract:BACKGROUND & AIMS:During chronic HCV infection, T cell dependent virus-specific antibodies are produced. However, the role of B-T cell interaction in chronic HCV is largely unknown. CD4(+)CXCR5(+) T follicular helper (TFH)-cells activate B cells and are important for clearance of various chronic viral infections. We in...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Spaan M,Kreefft K,de Graav GN,Brouwer WP,de Knegt RJ,ten Kate FJ,Baan CC,Vanwolleghem T,Janssen HL,Boonstra A

    更新日期:2015-02-01 00:00:00

  • Prognostic impact of surgery and radiofrequency ablation on single nodular HCC ⩽5 cm: Cohort study based on serum HCC markers.

    abstract:BACKGROUND & AIMS:Serological markers of hepatocellular carcinoma (HCC) indicate its invasiveness. We aimed to investigate whether the prognostic impact of surgical resection (SR) and radiofrequency thermal ablation (RFA) on patients with single nodular HCC ⩽5cm were different regarding positive conditions of the follo...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Ueno M,Hayami S,Shigekawa Y,Kawai M,Hirono S,Okada K,Tamai H,Shingaki N,Mori Y,Ichinose M,Yamaue H

    更新日期:2015-12-01 00:00:00

  • Microsteatosis may not interact with macrosteatosis in living donor liver transplantation.

    abstract:BACKGROUND & AIMS:The insignificance of pure microsteatosis (MiS) was reported in living donor liver transplantation (LDLT). However, since steatosis is mostly found in a mixed form of microsteatosis (MiS) and macrosteatosis (MaS), we aimed to determine the importance of MiS mixed with MaS in LDLT. METHODS:Donor match...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Han S,Ha SY,Park CK,Joh JW,Kwon CH,Kwon GY,Kim G,Gwak MS,Jeong WK,Ko JS

    更新日期:2015-03-01 00:00:00

  • Ethanol binging exacerbates sinusoidal endothelial and parenchymal injury elicited by acetaminophen.

    abstract:BACKGROUND/AIMS:The pathophysiology of binge drinking of ethanol and its potentiation of acetaminophen (APAP) toxicity has received very little attention. To evaluate if ethanol binging sensitizes hepatic sinusoidal endothelial cells (SEC) and liver to APAP toxicity. METHODS:The histopathological responses to APAP wer...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:2005-03-01 00:00:00

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:2007-12-01 00:00:00

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


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  • Gene transfer to the rat biliary tract with the HVJ-cationic liposome method.

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:1999-05-01 00:00:00

  • Transdermal oestrogen therapy protects postmenopausal liver transplant women from osteoporosis. A 2-year follow-up study.

    abstract:BACKGROUND/AIMS:Hormone replacement therapy (HRT) prevents osteoporosis in postmenopausal women by inhibiting bone resorption, but the benefits of oestrogen therapy in liver transplant patients have not been studied. METHODS:The effect of transdermal HRT was studied in 33 postmenopausal liver transplant women. The mai...

    journal_title:Journal of hepatology

    pub_type: 临床试验,杂志文章


    authors: Isoniemi H,Appelberg J,Nilsson CG,Mäkelä P,Risteli J,Höckerstedt K

    更新日期:2001-02-01 00:00:00

  • Possible association between poor metabolism of mephenytoin and hepatotoxicity caused by Atrium, a fixed combination preparation containing phenobarbital, febarbamate and difebarbamate.

    abstract::Drug hepatotoxicity is partially determined by genetic factors involved in drug metabolism, which may involve the debrisoquine oxidation polymorphism mediated by cytochrome (CYP) 2D6. The purpose of this study was to assess the relationship between drug hepatotoxicity and another genetic polymorphism of drug oxidation...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:1994-12-01 00:00:00

  • Multiple hepatic mitochondrial DNA deletions suggest premature oxidative aging in alcoholic patients.

    abstract:BACKGROUND/AIMS:A 4977-base pair deletion has been detected in the hepatic mitochondrial DNA of alcoholic patients with microvesicular steatosis, a lesion ascribed to impaired mitochondrial beta-oxidation. However, only a single deletion had been looked for in this previous study, and it could not be determined whether...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:1997-07-01 00:00:00

  • P60-c-src suppresses apoptosis through inhibition of caspase 8 activation in hepatoma cells, but not in primary hepatocytes.

    abstract:BACKGROUND/AIMS:Failure to induce apoptosis triggered by members of the death receptor family has been described in hepatocellular carcinoma (HCC) and sensitization of malignant cells to pro-apoptotic molecules such as TRAIL has been proposed as an alternative cancer therapy. Limiting to this approach are the resistanc...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:2007-04-01 00:00:00

  • Pathogenesis of lipid metabolism disorder in hepatitis C: polyunsaturated fatty acids counteract lipid alterations induced by the core protein.

    abstract:BACKGROUND & AIMS:Disturbance in lipid metabolism is one of the features of chronic hepatitis C, being a crucial determinant of the progression of liver fibrosis. Experimental studies have revealed that the core protein of hepatitis C virus (HCV) induces steatosis. METHODS:The activities of fatty acid metabolizing enz...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Miyoshi H,Moriya K,Tsutsumi T,Shinzawa S,Fujie H,Shintani Y,Fujinaga H,Goto K,Todoroki T,Suzuki T,Miyamura T,Matsuura Y,Yotsuyanagi H,Koike K

    更新日期:2011-03-01 00:00:00

  • Decrease in serum ALT and increase in serum HCV RNA during pregnancy in women with chronic hepatitis C.

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Gervais A,Bacq Y,Bernuau J,Martinot M,Auperin A,Boyer N,Kilani A,Erlinger S,Valla D,Marcellin P

    更新日期:2000-02-01 00:00:00

  • Regulation of hepatic stellate cell proliferation and collagen synthesis by proteinase-activated receptors.

    abstract:BACKGROUND/AIMS:Thrombin and MC tryptase, which are agonists for proteinase-activated receptors-1 and -2, respectively, are both increased in injured liver. We have examined if rat stellate cells express these receptors and if receptor agonists influence stellate cell activation. METHODS:Expression of mRNA for protein...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Gaça MD,Zhou X,Benyon RC

    更新日期:2002-03-01 00:00:00

  • Increasing hepatic arteriole wall thickness and decreased luminal diameter occur with increasing age in normal livers.

    abstract:BACKGROUND & AIMS:There is no data to suggest that the size of bile ducts, portal venules, and hepatic arterioles varies according to age in the normal human liver. We sought to examine whether hepatic arteriolar size, wall thickness, and luminal diameter change with increasing age. METHODS:Histologically normal liver...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Fiel MI,Deniz K,Elmali F,Schiano TD

    更新日期:2011-09-01 00:00:00

  • Evidence against a role for endotoxin in the hyperdynamic circulation of rats with prehepatic portal hypertension.

    abstract:BACKGROUND/AIMS:Excessive formation of nitric oxide may mediate the generalized vasorelaxation and hyporesponsiveness to vasoconstrictors observed in portal hypertensive states. Endotoxin, released from the bowel and detoxified by the liver, could stimulate inducible nitric oxide synthase directly or indirectly via the...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Chu CJ,Lee FY,Wang SS,Chang FY,Lin HC,Lu RH,Wu SL,Chan CC,Tai CC,Lai IN,Lee SD

    更新日期:1999-06-01 00:00:00

  • A controlled trial of prednisolone treatment in primary biliary cirrhosis. Three-year results.

    abstract::The results of a 3-year, placebo-controlled trial of prednisolone treatment in primary biliary cirrhosis (PBC) are presented. The active (n = 19) and placebo (n = 17) arms were initially well matched for age, menopausal status and disease severity. At 3 years hepatic symptoms were relatively improved in the prednisolo...

    journal_title:Journal of hepatology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Mitchison HC,Palmer JM,Bassendine MF,Watson AJ,Record CO,James OF

    更新日期:1992-07-01 00:00:00

  • Suramin inhibits duck hepatitis B virus DNA polymerase activity.

    abstract::Suramin, a polybasic anion, blocks the activity of the DNA polymerase encoded by the duck hepatitis B virus. The interaction with the virus was studied under conditions in which the property of the drug to bind with proteins was used with plasma obtained from infected ducks with viraemia. Inhibition of DNA polymerase ...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Tsiquaye K,Zuckerman A

    更新日期:1985-01-01 00:00:00

  • Influence of viral hepatitis on HIV infection.

    abstract::The natural history of HBV is known to be complicated by HIV-co-infection. In contrast, the effect of HBV on the outcome of patients infected with HIV-1 is controversial. Some cohort studies from the pre-HAART era described a more rapid progression to AIDS in patients carrying antibodies to the core-antigen or having ...

    journal_title:Journal of hepatology

    pub_type: 杂志文章,评审


    authors: Rockstroh JK

    更新日期:2006-01-01 00:00:00

  • The heart in liver transplantation.

    abstract::The heart and liver are organs that are closely related in both health and disease. Patients who undergo liver transplantation may suffer from heart disease that is: (a) related to the original cause of the liver disease such as hemochromatosis, (b) related to the liver disease itself, or (c) related to other associat...

    journal_title:Journal of hepatology

    pub_type: 杂志文章,评审


    authors: Ripoll C,Yotti R,Bermejo J,Bañares R

    更新日期:2011-04-01 00:00:00

  • Portal hemodynamics in chronic portal-systemic encephalopathy. Angiographic study in seven cases.

    abstract::A portal hemodynamic study was made in 7 consecutive patients with chronic portal-systemic encephalopathy by percutaneous transhepatic catheterization of the portal vein and injecting contrast medium into the superior mesenteric vein or by superior mesenteric arterial portography in comparison with patients without en...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:1985-01-01 00:00:00

  • O-GlcNAcylation-dependent upregulation of HO1 triggers ammonia-induced oxidative stress and senescence in hepatic encephalopathy.

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Görg B,Karababa A,Schütz E,Paluschinski M,Schrimpf A,Shafigullina A,Castoldi M,Bidmon HJ,Häussinger D

    更新日期:2019-11-01 00:00:00

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    abstract::We report eight cases of liver injury related to amoxycillin-clavulanate. Liver biopsy performed in seven patients revealed varying degrees of injury to interlobular bile ducts in all cases. Lesions included irregularity of the nuclei, vacuolization of the cytoplasm, lymphocytic infiltration, destruction and endotheli...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Hautekeete ML,Brenard R,Horsmans Y,Henrion J,Verbist L,Derue G,Druez P,Omar M,Kockx M,Hubens H

    更新日期:1995-01-01 00:00:00