TO THE EDITOR:
Immune thrombocytopenia (ITP) treatments during pregnancy include IV immunoglobulin (IVIg) and corticosteroids because of the reassuring safety data. There are limited safety data with respect to pregnancy and lactation for the thrombopoietin receptor agonists (TPO-RAs) romiplostim or eltrombopag. The largest retrospective study reports 15 pregnant individuals with ITP who used a TPO-RA during pregnancy with no attributable neonatal complications.1 Breastfeeding data were not systematically reported, but there was a case of thrombocytosis in a breastfed infant whose mother took eltrombopag in the postpartum period.1 Other preclinical studies and case reports have reported TPO-RA use during pregnancy2-8; 1 study recounts romiplostim use in a breastfeeding individual with no neonatal complications; however, no laboratory values were reported.9
We present a prospective case study of a 34-year-old postpartum individual who received romiplostim during her first pregnancy...
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