Thrombocytopenia - drug induced

Causes

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)

Exams 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

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.

Alternative Names

Drug-induced thrombocytopenia

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.

Update Date: 6/13/2011

Updated by: 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.