drug-induced thrombocytopenia

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Features:

  • commonly involves quinine, quinidine, sulphonamides, certain antibiotics e.g. cephalothin, heparin

  • the drug functions as a hapten, binds to the platelet, and fixes complement; intravascular lysis or removal by the reticuloendothelial system follows

  • platelet count falls rapidly within 2-3 days of taking a drug which has been taken previously; or 7 or more days after starting a new drug

  • count rises rapidly within 7 - 10 days of withdrawal except if drug metabolism is slow e.g. gold thiomalate, deiphenylhydantoin (Dilantin(R))

  • 3-25% incidence of heparin thrombocytopenia - uniquely demonstrates paradoxical thrombosis which improves after heparin withdrawal

  • chloramphenicol depresses platelet production

Last reviewed 01/2018

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