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Case Reports: Adverse drug reactions and complications
Severe thrombocytopenia after trastuzumab in a patient with HER2-positive serous endometrial cancer
  1. Celia Kucera,
  2. Nicole Chappell and
  3. Stephanie Wang
  1. Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
  1. Correspondence to Celia Kucera; ckucera{at}gwu.edu

Abstract

Trastuzumab is a humanised, monoclonal antibody that interferes with the human epidermal growth factor receptor 2 (HER2)/neu receptor and binds selectively to the HERB2 protein. It has been shown to prolong survival of patients with HER2-positive advanced uterine serous carcinoma.

We report the case of a woman in her 70s with HER2-positive metastatic papillary serous endometrial adenocarcinoma, who experienced severe thrombocytopenia related to trastuzumab administration. One week after the first dose of carboplatin/paclitaxel/trastuzumab combination chemotherapy, the patient was admitted to the hospital with vaginal bleeding, melena, petechiae and platelet counts of 0×109/L. The patient was suspected to have a severe trastuzumab-induced thrombocytopenia. A rapid and complete recovery was observed after multiple platelet transfusions, high-dose IV corticosteroids and immunoglobulin.

Among the 13 reported cases of trastuzumab-induced thrombocytopenia, this is the first case reported in the literature occurring in a patient with a gynecologic malignancy.

  • Cancer intervention
  • Haematology (drugs and medicines)
  • Obstetrics, gynaecology and fertility
  • Cancer - see Oncology
  • Gynecological cancer

https://doi.org/10.1136/bcr-2023-255181

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: CK, SW and NC. The following authors gave final approval of the manuscript: NC.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.