DRUG-INDUCED THROMBOTIC MICROANGIOPATHY CAUSED BY PONATINIB

Alexandra Mikó M.D., Ph.D., Renáta Csalódi M.D., Szabolcs Kosztolányi, M.D., Ágnes Nagy M.D., Ph.D., Árpád Szomor M.D., Ph.D., Orsolya Tóth M.D., Ph.D., Judit Pammer M.D., Zoltán Kohl M.D., Erzsébet Sziládi MD, Anett Balikó MD and Hussain Alizadeh* M.D., PhD

ABSTRACT

Drug-induced thrombotic microangiopathy (DITMA) is recognized as an important category of thrombotic microangiopathies, which is rare but a potentially serious condition caused by small-vessel platelet microthrombi. Main features are microangiopathic hemolytic anemia, thrombocytopenia, kidney injury, and neurological symptoms. Here we report the first case of a female patient who developed thrombotic microangiopathy after therapy with ponatinib. This case illustrates the difficulties in the differential diagnosis of DITMA and reminds us of the importance of blood smear in identifying the cause of thrombocytopenia. Many drugs can cause DITMA and here we highlight the tyrosine kinase inhibitors ponatinib as the culprit.

Keywords: Ponatinib, drug-induced, thrombotic microangiopathy.