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Thrombocytopenia - drug induced

  • Definition
    • Thrombocytopenia is any disorder in which there are not enough platelets. Platelets are cells in the blood that help the blood clot. A low platelet count makes bleeding more likely.

      When medicines or drugs are the causes of a low platelet count, it is called drug-induced thrombocytopenia.

  • Alternative Names
    • Drug-induced thrombocytopenia

  • Causes
    • Drug-induced thrombocytopenia occurs when certain medicines destroy platelets or interfere with the body's ability to make enough of them.

      There are two types of drug-induced thrombocytopenia: immune and nonimmune.

      If a medicine causes your body to produce antibodies, which seek and destroy your platelets, the condition is called drug-induced immune thrombocytopenia. Heparin, a blood thinner, is the most common cause of drug-induced immune thrombocytopenia.

      If a medicine prevents your bone marrow from making enough platelets, the condition is called drug-induced nonimmune thrombocytopenia. Chemotherapy drugs and a seizure medicine called valproic acid may lead to this problem.

      Other medicines that cause drug-induced thrombocytopenia include:

      • Furosemide
      • Gold, used to treat arthritis
      • Nonsteroidal anti-inflammatory drugs (NSAIDs)
      • Penicillin
      • Quinidine
      • Quinine
      • Ranitidine
      • Sulfonamides
      • Linezolid and other antibiotics
  • Symptoms
    • Decreased platelets may cause:

      • Abnormal bleeding
      • Bleeding when you brush your teeth
      • Easy bruising
      • Pinpoint red spots on the skin (petechiae)
  • Treatment
    • The first step is to stop using the medicine that is causing the problem.

      For people who have life-threatening bleeding, treatments may include:

      • Immunoglobulin therapy (IVIG) given through a vein
      • Plasma exchange (plasmapheresis)
      • Platelet transfusions
      • Corticosteroid medicine
  • Possible Complications
    • Bleeding can be life-threatening if it occurs in the brain or other organs.

      A pregnant woman who has antibodies to platelets may pass the antibodies to the baby in the womb.

  • When to Contact a Medical Professional
    • Call your healthcare provider if you have unexplained bleeding or bruising.

  • References
    • Abrams CS. Thrombocytopenia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 172.

      Warkentin TE. Thrombocytopenia caused by platelet destruction, hypersplenism, or hemodilution. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al., eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 134.