Abstract Details

Title Glatiramer Acetate Induced Thrombocytopenia

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 187

Objective

Background BACKGROUND: The effects of GA on hematologic derangement and the development of blood dyscrasias are poorly understood. GA is a premiere multiple sclerosis medication that has been on the market for sixteen years. Side effects are largely limited to injection site reactions, and in a small percentage of patients, an idiosyncratic reaction consisting of chest tightness, difficulty swallowing, anxiety, and shortness of breath that passes in several minutes. There has been only one case report of thrombocytopenia occurring with GA use. We report a second case.

Design/Methods DESIGN/METHODS: Case study.

Results RESULTS: A 72 year old man with history of multiple sclerosis and prior use of beta-interferon 1b, presented with worsening myelopathy. He had discontinued beta-interferon 1b after eight months because of flu-like symptoms, and had been off of all disease specific agents for 6 months prior to evaluation. There was no history of known hematologic disorder. His neurologic examination was significant for bilateral optic atrophy and myelopathy requiring a walker for ambulation. EDSS was 6.5. There was impressive lower extremity spasticity. Because of worsening myelopathy, the patient was begun on GA. A baseline platelet count was 248K with normal hematologic parameters otherwise. After 14 days of daily GA use, the patient's platelet count plunged to 40K, identified on a routine annual physical examination. This was a sustained value without other hematologic aberration. Upon discontinuance of GA, his platelet count rose to 296K.

Conclusions CONCLUSIONS: Ordinarily GA is viewed as having a benign side effect profile without significant alteration in hematologic parameters. We report a second case of thrombocytopenia associated with use of this medication. This case study suggests the need for vigilance with the use of GA and stresses the need to follow periodic blood work on patients who are taking this medication.

Authors/Disclosures
PRESENTER	No disclosure on file
Ronald O. Bailey, MD	No disclosure on file
	No disclosure on file
David Miller	No disclosure on file

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