Abstract

Drug-induced thrombocytopenia can be caused by dozens, perhaps hundreds of medications. Because thrombocytopenia can have many other causes, the diagnosis of drug-induced thrombocytopenia can easily be overlooked. In acutely ill, hospitalized patients, drug-induced thrombocytopenia can be overlooked because thrombocytopenia is attributed to sepsis, the effect of coronary-artery bypass surgery, or some other underlying condition. Although drug-induced thrombocytopenia is uncommon, it can be devastating. Heparin-induced thrombocytopenia is the most common drug-related cause of drop in the platelet count. Because heparin is often given together with certain drugs that are likely to cause drug-induced thrombocytopenia (platelet inhibitors and vancomycin), it is important to distinguish between heparin-induced thrombocytopenia and drug induced thrombocytopenia. Drug-induced platelet destruction is usually caused by drug-induced antibodies, but this can be difficult to prove. Although platelets are the preferred targets of drug-induced antibodies, drugs can also cause immune hemolytic anemia and neutropenia through similar mechanisms.

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