Secondary immune thrombocytopenic purpura with renal cell carcinoma

Abstract

Introduction Several types of cancers are reported to induce secondary immune thrombocytopenia resembling immune thrombocytopenic purpura‐like syndrome. However, renal cell carcinoma‐induced immune thrombocytopenic purpura is an extremely rare phenomenon. Case presentation A 73‐year‐old male with right renal tumor and multiple enlarged lymph nodes presented severe thrombocytopenia, without bone or hepatic metastasis. Although platelet transfusion and high‐dose immunoglobulin treatment were refractory, surgical resection of the tumor and lymph nodes promptly improved thrombocytopenia. After recurrence, he presented thrombocytopenia again. Tyrosine kinase inhibitor treatment was ceased due to uncontrollable hemorrhagic gastric ulcer. The patient eventually died of cancer 4 months after surgery. Flow cytometry analysis revealed the presence of integrin glycoprotein IIb/IIIa, which is a fibronectin/fibrinogen receptor on platelets and as an antigen in immune thrombocytopenic purpura. Conclusion To the best of our knowledge, this is the first reported case of renal cell carcinoma‐induced immune thrombocytopenic purpura that demonstrates the presence of platelet‐autoantibody glycoprotein IIb/IIIa.

A Rare Case of Thrombotic Thrombocytopenic Purpura (TTP) With Concurrent Renal Cell Carcinoma: Diagnostic and Therapeutic Challenges

“…For non-clear-cell RCC variants, response to checkpoint inhibitors suggests a dominant immune component in them as well [ 13 ]. More commonly, immune-mediated ITP has been reported in a handful of cases of RCC [ 14 , 15 ]. However, to our knowledge, to date, there has been no report of TTP in a treatment-naive RCC patient.…”