Drug-induced thrombocytopenia: clinical data on 309 cases and the effect of corticosteroid therapy

U Pedersen-Bjergaard, M Andersen, P B Hansen

    85 Citationer (Scopus)

    Abstract

    OBJECTIVE: To analyse the clinical picture and the course of thrombocytopenia induced by non-cytotoxic drugs, and to evaluate a possible therapeutic effect of corticosteroids.

    METHODS: A retrospective analysis of 309 well-documented cases of drug-induced thrombocytopenia was performed. Data sources were reports from the files of the Danish Committee on Adverse Drug Reactions and discharge summaries.

    RESULTS: The median length of exposure to the offending drug, before development of thrombocytopenia, was 21 days. The median nadir platelet count was 11 x 10(9).l-1, and 74% of the patients had clinical haemorrhage. Bone marrow examination generally showed hyperplastic reactive changes and a variable number of megakaryocytes. Slight leucopenia was present in 6% of the patients and 16% were anaemic. Complete recovery was seen in 87% of cases, with a median recovery rate of 8 days. The standard treatment was corticosteroids, which were administered in 53% of the cases. No difference in recovery between corticosteroid-treated and untreated patients was observed. No other clinical parameter affected the recovery rate. The mortality rate due to haemorrhage was 3.6%.

    CONCLUSION: Thrombocytopenia induced by non-cytotoxic drugs is characterised by heterogeneous clinical picture and recovery is generally rapid. Although corticosteroids seem inefficient, we still recommend that severe symptomatic cases of drug-induced thrombocytopenia are treated as idiopathic thrombocytopenic purpura due to the difficult initial differentiation between the two conditions.

    OriginalsprogEngelsk
    TidsskriftEuropean Journal of Clinical Pharmacology
    Vol/bind52
    Udgave nummer3
    Sider (fra-til)183-9
    Antal sider7
    ISSN0031-6970
    StatusUdgivet - 1997

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