Abstract
THROMBOCYTOPENIA due to drug sensitization is an uncommon but serious complication which may cause serious bleeding or lead to death from brain hemorrhage.1,2Although thrombocytopenia is present when the platelet count falls below the normal range of 200,000 to 400,000/cu mm (direct method), a significant bleeding tendency is usually not encountered in otherwise healthy persons unless the platelet count is less than 20,000/cu mm. In a person previously sensitized to a drug, reexposure to it may provoke a fulminant thrombocytopenia and purpura. Allergic manifestations such as wheezing, skin rash, and chills and fever also may develop. The thrombocytopenia results from immunologic damage to circulating platelets, leading to their premature removal from the blood3; bone marrow examination reveals numerous megakaryocytes which appear normal morphologically. The more important sensitizing drugs include quinidine, chlorothiazide, acetazolamide, sulfisoxazole, and phenylbutazone. The antibiotic, ristocetin, causes thrombocytopenia by a different mechanism—it is directly toxic to
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