Eltrombopag: Liver toxicity, kidney injury or assay interference?

Choy, Kay Weng; Wijeratne, Nilika; Doery, James C.G.

doi:10.1016/j.pathol.2015.12.144

Pathology

2016

DOI: 10.1016/j.pathol.2015.12.144

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Eltrombopag: Liver toxicity, kidney injury or assay interference?

Kay Weng Choy

Nilika Wijeratne

James C.G. Doery

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2019

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“…Therefore, some samples containing eltrombopag can visually appear hemolyzed and/or severely icteric . Furthermore, such samples can show analytical interference with some spectrophotometric assays, depending on the instrument, methodology and reagents used to measure the analyte (e.g., total bilirubin) . Some additional examples of medications that can cause plasma discoloration which may get confused with hemolysis or make visual hemolysis check challenging include iron dextran, hydroxocobalamin, atovaquone, and hemoglobin‐based oxygen carriers such as PEGylated carboxyhemoglobin bovine (SANGUINATE™) and HBOC‐201 (Hemopure™) .…”

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confidence: 99%

Transfusion confusion: hemolysis or eltrombopag?

Zakieh

Moayeri

2019

Transfusion

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A 71-year-old female with severe aplastic anemia developed nausea, abdominal/back pain, chest tightness, dyspnea, chills, headache, and blood pressure elevation after transfusion of 270 mL red blood cells. The transfusion was stopped and a reaction work-up initiated. The post-transfusion sample visual check was reported as "markedly hemolyzed," raising concern for a hemolytic transfusion reaction. However, a sample drawn 3 hours prior to this transfusion showed a similar appearance (see figure). Discussion with the referring physician and review of the patient's clinical history and labs confirmed she did not have pre-existing hemolysis. The post-transfusion direct antiglobulin test was negative, hemolysis labs (plasma free hemoglobin, lactate dehydrogenase, total and direct bilirubin) were within reference range, and her hemoglobin showed appropriate increment, ruling out a hemolytic transfusion reaction. The patient's symptoms resolved with systemic steroids and diphenhydramine. The reaction was signed out with a category of "unknown" given the findings did not fit case definitions for any other reaction as defined by the National Healthcare Safety Network (NHSN) hemovigilance module. 1 Further investigation revealed the patient was on 150 mg/day eltrombopag, which was causing the

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confidence: 99%

Transfusion confusion: hemolysis or eltrombopag?

Zakieh

Moayeri

2019

Transfusion

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Eltrombopag: Liver toxicity, kidney injury or assay interference?

Cited by 1 publication

References 0 publications

Transfusion confusion: hemolysis or eltrombopag?

Transfusion confusion: hemolysis or eltrombopag?

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