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Thrombocytopenia - drug induced

Drug-induced thrombocytopenia; Immune thrombocytopenia - drug

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-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, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2013:chap 134.

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  • 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

 

Review Date: 6/16/2017

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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