Thrombocytopenia| Meds (antibody Mediated Destruction)

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  • Thrombocytopenia| Meds (antibody mediated destruction)

Etiology

  • Meds can trigger antibody mediated platelet destruction
  • Heparin→ Heparin Induced Thrombocytopenia (HIT): Typically 50% decline w/in 5-10d of treatment, or < 1 d if prior exposure to heparin
  • Other Meds: H2-blockers, penicillins, NSAIDs, Quinine, Bactrim, Vancomycin, other antibiotics and meds of other classes

Risk Factors

  • For HIT, prior exposure to heparin

Symptoms

  • Bleeding and drop in platelets timed w/use of a medication
  • HIT: thrombocytopenia associated with arterial and/or venous thrombosis (e.g. skin necrosis, DVT, unexplained arterial thrombosis), adrenal hemorrhage, anaphylactic-type reaction after IV heparin infusion; 4Ts score can help w/diagnosis

Physical Exam Findings

  • Mucosal bleeding
  • DVT or otherwise unexplained arterial events, temporally related to heparin exposure

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