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The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report

The association between octreotide and thrombocytopenia has been documented in the literature but it remains a rare finding. We are reporting a 59-year-old female patient with alcoholic liver cirrhosis who presented with the gastrointestinal tract (GIT) bleeding secondary to esophageal varices. Init...

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Autores principales: Abu-Abaa, Mohammad, Jumaah, Omar, Chadalawada, Sindhu, Kananeh, Salman, Gugnani, Manish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981475/
https://www.ncbi.nlm.nih.gov/pubmed/36874323
http://dx.doi.org/10.7759/cureus.34590
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author Abu-Abaa, Mohammad
Jumaah, Omar
Chadalawada, Sindhu
Kananeh, Salman
Gugnani, Manish
author_facet Abu-Abaa, Mohammad
Jumaah, Omar
Chadalawada, Sindhu
Kananeh, Salman
Gugnani, Manish
author_sort Abu-Abaa, Mohammad
collection PubMed
description The association between octreotide and thrombocytopenia has been documented in the literature but it remains a rare finding. We are reporting a 59-year-old female patient with alcoholic liver cirrhosis who presented with the gastrointestinal tract (GIT) bleeding secondary to esophageal varices. Initial management involved fluid and blood products resuscitation and initiation of both octreotide and pantoprazole infusion. However, the abrupt onset of severe thrombocytopenia was evident within a few hours of admission. Platelet transfusion and discontinuation of pantoprazole infusion failed to correct the abnormality prompting the holding off of octreotide. However, this also failed to control the decline in platelet count and prompted intravenous immunoglobulin (IVIG). This case helps to remind clinicians to closely monitor platelet count once octreotide is initiated. This allows early detection of the rare entity of octreotide-induced thrombocytopenia, which can be life-threatening with extremely low platelet count nadir.
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spelling pubmed-99814752023-03-04 The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report Abu-Abaa, Mohammad Jumaah, Omar Chadalawada, Sindhu Kananeh, Salman Gugnani, Manish Cureus Gastroenterology The association between octreotide and thrombocytopenia has been documented in the literature but it remains a rare finding. We are reporting a 59-year-old female patient with alcoholic liver cirrhosis who presented with the gastrointestinal tract (GIT) bleeding secondary to esophageal varices. Initial management involved fluid and blood products resuscitation and initiation of both octreotide and pantoprazole infusion. However, the abrupt onset of severe thrombocytopenia was evident within a few hours of admission. Platelet transfusion and discontinuation of pantoprazole infusion failed to correct the abnormality prompting the holding off of octreotide. However, this also failed to control the decline in platelet count and prompted intravenous immunoglobulin (IVIG). This case helps to remind clinicians to closely monitor platelet count once octreotide is initiated. This allows early detection of the rare entity of octreotide-induced thrombocytopenia, which can be life-threatening with extremely low platelet count nadir. Cureus 2023-02-03 /pmc/articles/PMC9981475/ /pubmed/36874323 http://dx.doi.org/10.7759/cureus.34590 Text en Copyright © 2023, Abu-Abaa et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Gastroenterology
Abu-Abaa, Mohammad
Jumaah, Omar
Chadalawada, Sindhu
Kananeh, Salman
Gugnani, Manish
The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report
title The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report
title_full The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report
title_fullStr The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report
title_full_unstemmed The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report
title_short The Clinical Challenge of Refractory Octreotide-Induced Thrombocytopenia in Active Gastrointestinal Bleeding: A Case Report
title_sort clinical challenge of refractory octreotide-induced thrombocytopenia in active gastrointestinal bleeding: a case report
topic Gastroenterology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981475/
https://www.ncbi.nlm.nih.gov/pubmed/36874323
http://dx.doi.org/10.7759/cureus.34590
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