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Thrombocytopenia - drug induced

Drug-induced thrombocytopenia

 

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.

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.

 
  • Blood clot formation - illustration

    Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.

    Blood clot formation

    illustration

  • Blood clots - illustration

    Blood clots (fibrin clots) are the clumps that result when blood coagulates.

    Blood clots

    illustration

    • Blood clot formation - illustration

      Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.

      Blood clot formation

      illustration

    • Blood clots - illustration

      Blood clots (fibrin clots) are the clumps that result when blood coagulates.

      Blood clots

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Thrombocytopenia - drug induced

         

           

          Review Date: 6/22/2015

          Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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