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\begin{document}

\title{Rituximab-induced severe acute thrombocytopenia in a patient with
splenic marginal zone lymphoma}



\author[1]{Taha Ulutan Kars}%
\author[1]{Zahit Furkan Yorgancı}%
\author[1]{Osman Yaşkıran}%
\author[1]{Atakan Tekinalp}%
\author[1]{Sinan Demircioğlu}%
\affil[1]{Necmettin Erbakan University Meram Faculty of Medicine}%


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  \date{September 18, 2024}


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\begin{abstract}
Introduction: Rituximab, which is widely used in the treatment of B-cell
lymphoma, is a chimeric monoclonal antibody directed against the CD20
antigen. Rituximab has many side effects, mainly allergic and
neurological. Rituximab may cause thrombocytopenia in the long term
after administration. Rare cases with rituximab-induced acute
thrombocytopenia have been reported in the literature. Case Report: A
51-year-old female patient who newly diagnosed splenic marginal zone
lymphoma recieved rituximab as first line therapy. Petechiae occurred in
the lower extremities on the day following rituximab administration. The
blood test showed a severe drop in the platelet count from 112,000/\selectlanguage{greek}μ\selectlanguage{english}L to
5,000/\selectlanguage{greek}μ\selectlanguage{english}L. Blood peripheral smear evaluation confirmed severe
thrombocytopenia. Management and outcome: There was no change in
hemoglobin or white blood cell levels. After the diagnosis of
rituximab-induced acute thrombocytopenia, thrombocyte suspension was
administered due to the risk of bleeding. Close clinical and laboratory
observations were made. The platelet count began to rise gradually in
the following period. Before the second week of rituximab
administration, the platelet count was 122,000/\selectlanguage{greek}μ\selectlanguage{english}L. No complications
developed after premedication and slow rituximab administration, and
subsequent treatments were continued in the same way. Discussion:
Rituximab has a widespread use, especially in malignancies and
autoimmune diseases. Like many monoclonal antibodies, rituximab has
several side effects. Thrombocytopenia is a long-term side effect
associated with rituximab, and rituximab-induced severe acute
thrombocytopenia has been rarely reported. Therefore, it should be kept
in mind that severe acute thrombocytopenia may develop after rituximab
administration.%
\end{abstract}%



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