Secondary immune thrombocytopenic purpura with renal cell carcinoma

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.

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.

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.