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Thrombocytopenia - drug induced

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

See also: Thrombocytopenia

Alternative Names

Drug-induced thrombocytopenia

Causes, incidence, and risk factors

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

There are two types of drug-induced thrombocytopenia:

  • Immune
  • Nonimmune

If a drug 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 probably 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 medication called valproic acid may lead to this problem.

Other drugs that cause drug-induced thrombocytopenia include:

  • Furosemid
  • Gold, used to treat arthritis
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Penicillin
  • Quinidine
  • Quinine
  • Ranitidine
  • Sulfonamides

Symptoms

Decreased platelets may cause:

  • Abnormal bleeding
  • Bleeding when you brush your teeth
  • Easy bruising
  • Pinpoint red spots on the skin (petechiae )

Signs and tests

See: Thrombocytopenia

Treatment

The first step in treating this type of low platelet count is to stop using the drug that may be 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

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.

Calling your health care provider

Call your healthcare provider if you have unexplained bleeding or bruising.

References

Warkentin TE. Thrombocytopenia due to platelet destruction and hypersplenism. In: Hoffman R, Benz EJ Jr, Shattil SJ, et al, eds. Hoffman Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 140.

McMillan R. Hemorrhagic disorders: abnormalities of platelet and vascular function. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 179.

Updated: 6/13/2011

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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