Immuno-thrombocytopenia drug-induced D69.-

Ackroyd

In 1949, acute thrombopenia was observed for the first time, which could be attributed to the drug sedormide, an allyl-isopropyl-acetylcarbamide. This is a reaction in which certain drugs act as haptens.

Drugs form an immune complex with plasma proteins, whereupon B cells form antibodies against this complex. A complex of drug, protein and antibody is formed, which adsorbs on the platelet surface.
After activation of the complement, the thrombocytes are lysed into the bloodstream. Without complement activation, the immune complexes are destroyed after opsonation in the RES.

Drugs and chemicals that can trigger immune thrombocytopenia:

• Quinone alloids: quinine, quinidine
• Sedatives: L-Lisopropylacetylurea (sedormide), meprobamate, barbiturates
• Antibiotics: tetracyclines, chloramphenicol, streptomycin, ristocetin, paraaminosalicylic acid, vacomycin
• Antibacterial sulfonamides: sulfisoxazole (gantrisine), sulfadiazine, sulfamethazine, sulfamethoxypyridine
• Other sulphonamide derivatives: tolbutamide, chlorothiazide, acetazolamide (diamox), chlorpropamide, diazoxide
• Other substances: dinitrophenol, gold, bismuth, mercury compounds, arsenic, potassium iodide, digitoxin, danazol, estrogens, ergot alkaloids, thrioar substance, carbamazepine, amophotericin B.

1. HA Neumann (2014) The coagulation system. ABW-Wissenschaftsverlag GmbH Berlin S. 136f.