Cerebral Venous Thrombosis Involving the Vein of Labbé and Left Sigmoid Sinus in a Patient With Immune Thrombocytopenia Treated With Romiplostim: A Case Report and Literature Review
Case report published in Cureus (2026)
Abstract
Cerebral venous thrombosis is an uncommon but potentially serious condition primarily affecting young women. Thrombosis of the vein of Labbé is a rare site of thrombosis linked to hemorrhagic venous infarction. Thrombotic events have been reported in patients with chronic primary immune thrombocytopenia (ITP) treated with thrombopoietin receptor agonists (TPO-RAs). A 33-year-old woman with chronic ITP, treated with romiplostim for five years, presented with a progressively worsening occipital headache and a generalized seizure. Computed tomography showed a left parietotemporal intraparenchymal hemorrhage. Magnetic resonance imaging and venography confirmed left sigmoid sinus thrombosis and a hemorrhagic venous infarction caused by thrombosis of the vein of Labbé, along with signs indicating a previous superior sagittal sinus thrombosis. Romiplostim was discontinued after the event, and anticoagulation, along with corticosteroids, was started due to a decline in platelet count. Common causes of cerebral venous thrombosis were investigated and ruled out. The patient was discharged asymptomatic on hospital day 12 and was seen for outpatient follow-up. This case highlights a rare presentation of Labbé vein thrombosis in the setting of long-term use of TPO-RAs and supports a possible association.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Cerebral venous thrombosis is an uncommon but potentially serious condition primarily affecting young women. Thrombosis of the vein of Labbé is a rare site of thrombosis linked to hemorrhagic venous infarction.
Por qué esto importa para la hirudoterapia
Este informe de caso con revisión de la literatura describe a una mujer de 33 años con trombocitopenia inmune crónica (ITP) tratada con el agonista del receptor de trombopoyetina romiplostim durante cinco años, quien desarrolló trombosis venosa cerebral que afectaba la vena de Labbé y el seno sigmoideo izquierdo con infarto venoso hemorrágico; se suspendió el romiplostim y se inició anticoagulación más corticosteroides, y fue dada de alta asintomática el día 12, argumentando los autores que el caso respalda una posible asociación entre el uso a largo plazo de agonistas del receptor de TPO y la trombosis. Para la hirudoterapia, esto sirve como recordatorio de que la trombosis venosa puede ser desencadenada paradójicamente por terapias que aumentan el recuento plaquetario y puede coexistir con recuentos plaquetarios bajos, una combinación que exige extrema precaución antes de cualquier procedimiento que induzca sangrado local, como la aplicación de sanguijuelas. Como un único informe de caso, puede sugerir pero no establecer una causalidad, y no implica ninguna hirudoterapia; se incluye únicamente como contexto ilustrativo de trombosis venosa.
Citación
Cerebral Venous Thrombosis Involving the Vein of Labbé and Left Sigmoid Sinus in a Patient With Immune Thrombocytopenia Treated With Romiplostim: A Case Report and Literature Review.
Berrocal C et al. · Cureus, 2026
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026