Thrombocytopenia due to the use of rifampicin in brucellosis

Abstract

Abstract. Thrombocytopenia may develop after drug therapy and is a life-threatening condition. Thrombocytopenia may also occur after high-dose use of rifampicin which is an antibiotic.  Here, we report five cases of thrombocytopenia developing after the use of rifampicin for the treatment of brucellosis. Four cases had experienced diffuse petechiae and ecchymosis with severe thrombocytopenia. The other patient had a complicated thrombocytopenia with intracerebral hemorrhage. As a result, the usage of rifampicin in the treatment of brucellosis could lead to systemic or central complications.

Key words: Brucellosis, rifampicin, thrombocytopenia

Keywords

• Brucellosis, rifampicin, thrombocytopenia

Kaynakça

1. Mc Crae KR, Cines DB. Drug-induced thrombocytopenias. In: Loscalzo J, Schafer AI, eds. Thrombosis and Hemorrhage. Cambridge, USA: Blackwell Scientific Pub 1994: 545-573.
2. George JN, Raskob GE, Shah SR, et al. Drug-induced thrombocytopenia: a systematic review of published case reports. Ann Intern Med 1998; 129: 886-890.
3. Sepulveda R, Soerensen R, Santiviago C, et al. Thrombocytopenia caused by hypersensitivity to rifampicin in intermittent high doses. Rev Med Chil 1971; 99: 934-938.
4. Kakaiya RM, Dehertogh D, Walker FJ, Cummings E, Uzdejczyk M. Rifampin induced immune thrombocytopenia. A case report. Vox Sang 1989; 57: 185-187.
5. Lee CH, Lee CJ. Thrombocytopenia: a rare but potentially serious side effect of initial daily and interrupted use of rifampicin. Chest 1989; 96: 202- 203.
6. Mehta YS, Jijina FF, Badakere SS, Pathare AV, Mohanty D. Rifampicin-induced immune thrombocytopenia.Tuber Lung Dis 1996; 77: 558-562.
7. Blajchman MA, Lowry RC, Pettit JE, Stradling P. Rifampicin-induced immune thrombocytopenia. Br Med J 1970; 3: 24-26.
8. Ferguson GC. Rifampicin and thrombocytopenia. Br Med J 1971; 3: 638.

9. Akin M, Turgut S, Ayada C, et al. Relation between 3435C>T multidrug resistance 1 gene polymorphism with high dose methylprednisolone treatment of childhood acute idiopathic thrombocytopenic purpura. Gene 2011; 487: 80-83.
10. Oner AF, Bay A, Kuru M, et al. Effects of high-dose methylprednisolone therapy on coagulation factors in patients with acute immune thrombocytopenic purpura. Clin Appl Thromb Hemost 2005; 11: 489- 492.
11. Ozsoylu S. Comparison of intravenous immunoglobulin and high dose anti-D immunoglobulin as initial therapy for childhood immune thrombocytopenic purpura. Br J Haematol 2011; 152: 783-784.
12. Weintraub RM, Pechet L, Alexander B. Rapid diagnosis of drug-induced thrombocytopenic purpura. Report of three cases due to quinine, quinidine, and Dilantin. JAMA 1962; 180: 528-532.
13. Connellan JM, Deacon S, Thurlow PJ. Changes in platelet function and reactivity induced by quinine in relation to quinine (drug) induced immune thrombocytopenia. Thromb Res 1991; 61: 501-514.
14. Curtis BR, McFarland JG, Wu GG, Visentin GP, Aster RH. Antibodies in sulfonamide-induced immune thrombocytopenia recognize calcium-dependent epitopes on the glycoprotein IIb/IIIa complex. Blood 1994; 84: 176-183.
15. Martinez E, Muniz E, Doningo P. Evidence implicating rifampicin-independent antiplatelet antibodies in the pathogenesis of rifampicin-induced immune thrombocytopenia. Clin Infect Dis 1994; 19: 351-353.
16. Bajjoka AE. Ranitidine-induced thrombocytopenia. Arch Intern Med 1991; 151: 203.
17. Hong Kong Tuberculosis Treatment Services/ BMRC. A controlled trial of daily and intermittent rifampicin plus ethambutol in the retreatment of patients with pulmonary tuberculosis: results up to 30 months. Tubercle 1975; 56: 179-189.
18. Juang YC, Tsao TC, Chiang YC, Lin JL, Tsai YH. Acute renal failure and severe thrombocytopenia induced by rifampicin: report of a case. J Formos Med Assoc 1992; 91: 475-476.
19. Poole G, Stradling P, Worlledge S. Potentially serious side effects of high-dose twice-weekly rifampicin. Br Med J 1971; 3: 343-347.
20. Kahn RA. Clinical evaluation of platelet transfusions in thrombocytopenic patients: methods and interpretation. Vox Sang 1981; 1: 87-97.
21. Zucker MB, Lundberg A. Platelet transfusions. Anesthesiology 1966; 27: 385-398.
22. Akdeniz H, Irmak H, Seckinli T, Buzgan T, Demiroz AP. Hematological manifestations in brucellosis cases in Turkey. Acta Med Okayama 1998; 52: 63-65.
23. Crosby E, Llosa L, Quesada MM, Carrillo C, Gotuzzo E. Hematologic changes in brucellosis. J Infect Dis 1984; 150: 419-424.
24. Aysha MH, Shayip MA. Pancytopenia and other haematological findings in brucellosis. Scand J Haematol 1986; 36: 335-338.