{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:13:01Z","timestamp":1783732381912,"version":"3.55.0"},"reference-count":14,"publisher":"American Animal Hospital Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A 4 yr old spayed female Kerry blue terrier was presented for pancytopenia secondary to an azathioprine overdose at a referral hospital. The dog was initially prescribed prednisone at 1 mg\/kg q 24 hr and azathioprine at 1.6 mg\/kg q 24 hr for immune-mediated polyarthropathy. Over 12 wk, the doses were tapered following clinical remission of immune-mediated polyarthropathy. For an unknown period, owner dosing error suggested a drug overdose of azathioprine at 4.8 mg\/kg every other day instead of the prescribed 1.6 mg\/kg every other day dose. The drugs were discontinued, and the dog presented for bone marrow failure and associated pancytopenia. Romiplostim was administered at 5 \u03bcg\/kg subcutaneously on three time points (upon initial presentation to the referral facility, day 8 after initial presentation, and day 15 after initial presentation). Repeat bloodwork at the different time points revealed improvement of the pancytopenia. Romiplostim has been used exclusively for thrombocytopenia in dogs; however, literature in humans and mice models suggests that it can influence multiple cell lines. This case report suggests that romiplostim administration can be considered in cases of pancytopenia and may accelerate bone marrow recovery.<\/jats:p>","DOI":"10.5326\/jaaha-ms-7513","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:17:25Z","timestamp":1776824245000},"page":"123-126","source":"Crossref","is-referenced-by-count":0,"title":["Romiplostim Use in Pancytopenia Secondary to Azathioprine Overdose in a Dog"],"prefix":"10.5326","volume":"62","author":[{"given":"Jay","family":"Pakhawala","sequence":"first","affiliation":[{"name":"From the Department of Internal Medicine, The Schwarzman Animal Medical Center, New York, NY (J.P., D.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Palma","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, The Schwarzman Animal Medical Center, New York, NY (J.P., D.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3280","reference":[{"issue":"9","key":"i1547-3317-62-3-123-b1","series-title":"J Am Vet Med Assoc","first-page":"1316","article-title":"Azathioprine for treatment of immune-mediated diseases of dogs and cats","volume":"192","author":"Beale","year":"1988","unstructured":"Beale KM. Azathioprine for treatment of immune-mediated diseases of dogs and cats. J Am Vet Med Assoc 1988;192(9):1316\u20138."},{"issue":"10","key":"i1547-3317-62-3-123-b2","series-title":"Can Vet J","first-page":"612","article-title":"Azathioprine-induced bone marrow toxicity in four dogs","volume":"37","author":"Rinkardt","year":"1996","unstructured":"Rinkardt NE, Kruth SA. Azathioprine-induced bone marrow toxicity in four dogs. Can Vet J 1996;37(10):612\u20133."},{"issue":"8","key":"i1547-3317-62-3-123-b3","series-title":"Can Vet J","first-page":"496","article-title":"Acute pancreatitis and bone marrow suppression in a dog given azathioprine","volume":"32","author":"Houston","year":"1991","unstructured":"Houston DM, Taylor JA. Acute pancreatitis and bone marrow suppression in a dog given azathioprine. Can Vet J 1991;32(8):496\u20137."},{"issue":"4","key":"i1547-3317-62-3-123-b4","series-title":"J Vet Intern Med","first-page":"2158","article-title":"Romiplostim for treatment of thrombocytopenia in dogs: a retrospective assessment and clinical outcomes","volume":"38","author":"Ryu","year":"2024","unstructured":"Ryu MO, Kim JK, An JH,  Romiplostim for treatment of thrombocytopenia in dogs: a retrospective assessment and clinical outcomes. J Vet Intern Med 2024;38(4):2158\u201364."},{"key":"i1547-3317-62-3-123-b5","series-title":"Top Companion Anim Med","first-page":"100488","article-title":"Romiplostim as adjunctive treatment of refractory amegakaryocytic immune thrombocytopenia in a dog","volume":"42","author":"Polydoros","year":"2021","unstructured":"Polydoros T, Ioannidi OM, Korsavvidis I,  Romiplostim as adjunctive treatment of refractory amegakaryocytic immune thrombocytopenia in a dog. Top Companion Anim Med 2021;42:100488."},{"issue":"1","key":"i1547-3317-62-3-123-b6","series-title":"BMC Vet Res","first-page":"290","article-title":"Erratum to: treatment of 5 dogs with immune-mediated thrombocytopenia using romiplostim","volume":"12","author":"Kohn","year":"2016","unstructured":"Kohn B, Bal G, Chirek A,  Erratum to: treatment of 5 dogs with immune-mediated thrombocytopenia using romiplostim. BMC Vet Res 2016;12(1):290."},{"issue":"6","key":"i1547-3317-62-3-123-b7","series-title":"Exp Hematol","first-page":"479","article-title":"Romiplostim promotes platelet recovery in a mouse model of multicycle chemotherapy-induced thrombocytopenia","volume":"43","author":"McElroy","year":"2015","unstructured":"McElroy PL, Wei P, Buck K,  Romiplostim promotes platelet recovery in a mouse model of multicycle chemotherapy-induced thrombocytopenia. Exp Hematol 2015;43(6):479\u201387."},{"issue":"12","key":"i1547-3317-62-3-123-b8","series-title":"Ann Hematol","first-page":"2045","article-title":"Effect of thrombopoietin receptor agonists on leukocyte and haematopoietic stem and progenitor cells in the peripheral blood of patients with immune thrombocytopenic purpura","volume":"96","author":"Bal","year":"2017","unstructured":"Bal G, Fabian D, Maia D,  Effect of thrombopoietin receptor agonists on leukocyte and haematopoietic stem and progenitor cells in the peripheral blood of patients with immune thrombocytopenic purpura. Ann Hematol 2017;96(12):2045\u201356."},{"issue":"6","key":"i1547-3317-62-3-123-b9","series-title":"Compend Contin Educ Vet","first-page":"E2","article-title":"Drug-associated blood cell dyscrasias","volume":"34","author":"Weiss","year":"2012","unstructured":"Weiss DJ. Drug-associated blood cell dyscrasias. Compend Contin Educ Vet 2012;34(6):E2."},{"issue":"2","key":"i1547-3317-62-3-123-b10","series-title":"J Vet Intern Med","first-page":"513","article-title":"Incidence, timing, and risk factors of azathioprine hepatotoxicosis in dogs","volume":"29","author":"Wallisch","year":"2015","unstructured":"Wallisch K, Trepanier LA. Incidence, timing, and risk factors of azathioprine hepatotoxicosis in dogs. J Vet Intern Med 2015;29(2):513\u20138."},{"key":"i1547-3317-62-3-123-b11","series-title":"Blood Rev","first-page":"101222","article-title":"Immune thrombocytopenia: pathophysiology and impacts of romiplostim treatment","volume":"67","author":"Semple","year":"2024","unstructured":"Semple JW, Schifferli A, Cooper N,  Immune thrombocytopenia: pathophysiology and impacts of romiplostim treatment. Blood Rev 2024;67:101222."},{"issue":"1","key":"i1547-3317-62-3-123-b12","series-title":"Cureus","first-page":"e78228","article-title":"Romiplostim in aplastic anemia: a single-center retrospective study","volume":"17","author":"Ramanan","year":"2025","unstructured":"Ramanan V, Kelkar K. Romiplostim in aplastic anemia: a single-center retrospective study. Cureus 2025;17(1):e78228."},{"issue":"9","key":"i1547-3317-62-3-123-b13","series-title":"Am J Health Syst Pharm","first-page":"817","article-title":"Romiplostim: a novel thrombopoiesis-stimulating agent","volume":"66","author":"Perreault","year":"2009","unstructured":"Perreault S, Burzynski J. Romiplostim: a novel thrombopoiesis-stimulating agent. Am J Health Syst Pharm 2009;66(9):817\u201324."},{"key":"i1547-3317-62-3-123-b14","series-title":"Blood Adv","first-page":"1415","article-title":"Long-term efficacy and safety of romiplostim in refractory aplastic anemia: follow-up of a phase 2\/3 study","volume":"8","author":"Mitani","year":"2024","unstructured":"Mitani K, Lee JW, Jang JH,  Long-term efficacy and safety of romiplostim in refractory aplastic anemia: follow-up of a phase 2\/3 study [published correction appears in Blood Adv 2024;8(23):6097]. Blood Adv 2024;8:1415\u20139."}],"container-title":["Journal of the American Animal Hospital Association"],"original-title":[],"link":[{"URL":"https:\/\/jaaha.kglmeridian.com\/view\/journals\/aaha\/62\/3\/article-p123.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jaaha.kglmeridian.com\/downloadpdf\/journals\/aaha\/62\/3\/article-p123.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jaaha.kglmeridian.com\/downloadpdf\/journals\/aaha\/62\/3\/article-p123.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:31:17Z","timestamp":1783729877000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaaha.kglmeridian.com\/view\/journals\/aaha\/62\/3\/article-p123.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":14,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5326\/jaaha-ms-7513","relation":{},"ISSN":["1547-3317","0587-2871"],"issn-type":[{"value":"1547-3317","type":"electronic"},{"value":"0587-2871","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,1]]}}}