Publications Scientifiques

[ Article ] Pathophysiology and Diagnosis of Drug-Induced Immune Thrombocytopenia

Date de soumission: 08-02-2021
Année de Publication: 2020
Entité/Laboratoire Laboratoire d'hématologie (LH)
Document type : Article
Discipline(s) : Hématologie
Titre Pathophysiology and Diagnosis of Drug-Induced Immune Thrombocytopenia
Auteurs Vayne Caroline [1], Guéry Eve-Anne [2], Rollin Jérôme [3], BAGLO TATIANA [4], Petermann Rachel [5], Gruel Yves [6],
Journal: Journal of Clinical Medicine
Catégorie Journal: Internationale
Impact factor: 0
Volume Journal: 9
DOI: doi:10.3390/jcm9072212
Resume Drug-induced immune thrombocytopenia (DITP) is a life-threatening clinical syndrome that is under-recognized and dicult 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 di erent 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 dicult 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 a ected patients usually have thrombotic complications but do not bleed. In addition, laboratory tests are readily available to diagnose HIT, unlike the methods used to detect DDabs associated with other DITP that are mostly reserved for laboratories specialized in platelet immunology.
Mots clés platelets; thrombocytopenia; drugs; heparin-induced thrombocytopenia
Pages 1 - 19
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