Romiplostim use in immune thrombocytopenia: Experience in Cuenca, Ecuador.

Introduction. The international consensus and the American Society of Hematology guidelines from 2019 established thrombopoietin analogues as the second-line therapy for primary immune thrombocytopenia cases. Objectives.

[Primary immune thrombocytopenia linked to the ingestion of guinea pigs (Cavia porcellus) causality or coincidence?].

The guinea pig in Ecuador is synonymous with our ancestral gastronomy and cultural tradition, but because of the diet rich in L-canavanine (alfalfa) that they receive; could limit its consumption in patients with primary immune thrombocytopenia (ITP). Ingestion of alfalfa in humans can cause kidney failure and lupus-like syndrome. The John Hopkins Lupus Center recommends avoiding it in the diet of patients with Systemic Lupus Erythematosus (SLE), as it aggravates inflammation by stimulating immune activity (flares).