Pathophysiology and Diagnosis of Drug-Induced Immune Thrombocytopenia

Journal of Clinical Medicine
Caroline VayneYves Gruel

Abstract

Drug-induced immune thrombocytopenia (DITP) is a life-threatening clinical syndrome that is under-recognized and difficult to diagnose. Many drugs can cause immune-mediated thrombocytopenia, but the most commonly implicated are abciximab, carbamazepine, ceftriaxone, eptifibatide, heparin, ibuprofen, mirtazapine, oxaliplatin, penicillin, quinine, quinidine, rifampicin, suramin, tirofiban, trimethoprim-sulfamethoxazole, and vancomycin. Several different mechanisms have been identified in typical DITP, which is most commonly characterized by severe thrombocytopenia due to clearance and/or destruction of platelets sensitized by a drug-dependent antibody. Patients with typical DITP usually bleed when symptomatic, and biological confirmation of the diagnosis is often difficult because detection of drug-dependent antibodies (DDabs) in the patient's serum or plasma is frequently not possible. This is in contrast to heparin-induced thrombocytopenia (HIT), which is a particular DITP caused in most cases by heparin-dependent antibodies specific for platelet factor 4, which can strongly activate platelets in vitro and in vivo, explaining why affected patients usually have thrombotic complications but do not bleed. In addition, laboratory t...Continue Reading

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Citations

Nov 4, 2020·Clinical Science·Sarah M HicksElizabeth E Gardiner
Jan 2, 2021·International Journal of Molecular Sciences·Paweł ŚledzińskiJoanna Zeyland
Jun 16, 2021·BMJ Case Reports·Pranav MahajanNaveed Adoni
Jul 28, 2021·BMJ Case Reports·Thakul RattanasuwanAdonice P Khoury
Sep 8, 2021·BMJ Case Reports·Aishwarya SharmaAmit Kaushal
Sep 10, 2021·European Journal of Hospital Pharmacy. Science and Practice·Mengen LvQian Yu
Nov 4, 2021·Journal of Clinical Pharmacy and Therapeutics·Rebecca BystromVatche Tchekmedyian

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BETA
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flow cytometry

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