Drug-induced thrombocytopenia: pathogenesis, evaluation, and management. Hematology Am Soc Hematol Educ Program 2009:153-8
Date
12/17/2009Pubmed ID
20008194Pubmed Central ID
PMC4413903DOI
10.1182/asheducation-2009.1.153Scopus ID
2-s2.0-77949434753 (requires institutional sign-in at Scopus site) 231 CitationsAbstract
Although drugs are a common cause of acute immune-mediated thrombocytopenia in adults, the drug etiology is often initially unrecognized. Most cases of drug-induced thrombocytopenia (DITP) are caused by drug-dependent antibodies that are specific for the drug structure and bind tightly to platelets by their Fab regions but only in the presence of the drug. A comprehensive database of 1301 published reports describing 317 drugs, available at www.ouhsc.edu/platelets, provides information on the level of evidence for a causal relation to thrombocytopenia. Typically, DITP occurs 1 to 2 weeks after beginning a new drug or suddenly after a single dose when a drug has previously been taken intermittently. However, severe thrombocytopenia can occur immediately after the first administration of antithrombotic agents that block fibrinogen binding to platelet GP IIb-IIIa, such as abciximab, tirofiban, and eptifibatide. Recovery from DITP usually begins within 1 to 2 days of stopping the drug and is typically complete within a week. Drug-dependent antibodies can persist for many years; therefore, it is important that the drug etiology be confirmed and the drug be avoided thereafter.
Author List
George JN, Aster RHAuthor
Richard H. Aster MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAdverse Drug Reaction Reporting Systems
Antibody Specificity
Antigens, Human Platelet
Autoantibodies
Beverages
Case-Control Studies
Child
Databases, Factual
Diagnosis, Differential
Drug-Related Side Effects and Adverse Reactions
Epitopes
Fibrinolytic Agents
Food
Humans
Immunologic Memory
Immunosuppressive Agents
Platelet Transfusion
Purpura, Thrombocytopenic, Idiopathic
Thrombocytopenia
