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) 205 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 RHMESH 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
