Isoniazid-induced Immune Thrombocytopenia

Drug-induced thrombocytopenia occurs through immune-mediated platelet destruction, and its management is challenging during tuberculosis treatment. Although rifampicin is the most common drug causing thrombocytopenia, isoniazid can also cause thrombocytopenia. We herein report a 75-year-old man who...

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Bibliographic Details
Published in:Internal Medicine 2021/11/15, Vol.60(22), pp.3639-3643
Main Authors: Kuwabara, Gaku, Tazoe, Kumiyo, Imoto, Waki, Yamairi, Kazushi, Shibata, Wataru, Oshima, Kazuhiro, Yamada, Koichi, Takagi, Yasuhiro, Shiraishi, Satoshi, Hino, Masayuki, Kawaguchi, Tomoya, Kakeya, Hiroshi
Format: Article
Language:English
Subjects:
Aged
Case Report
drug-induced immune thrombocytopenia
Humans
Idiopathic thrombocytopenic purpura
Immunoglobulin G
Internal medicine
Isoniazid
Isoniazid - adverse effects
Lymphocytes
Male
Platelet Count
Platelets
Purpura, Thrombocytopenic, Idiopathic - chemically induced
Purpura, Thrombocytopenic, Idiopathic - diagnosis
Rifampin
Thrombocytopenia
Thrombocytopenia - chemically induced
Thrombocytopenia - diagnosis
Thrombocytosis
Tuberculosis
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Summary:Drug-induced thrombocytopenia occurs through immune-mediated platelet destruction, and its management is challenging during tuberculosis treatment. Although rifampicin is the most common drug causing thrombocytopenia, isoniazid can also cause thrombocytopenia. We herein report a 75-year-old man who developed thrombocytopenia during tuberculosis treatment. Platelet-associated immunoglobulin G and a drug-induced lymphocyte stimulation test for isoniazid were positive; no other causes of thrombocytopenia were identified. The patient was diagnosed with isoniazid-induced immune thrombocytopenia, and the platelet count normalized after isoniazid discontinuation. We describe the immunological mechanism of thrombocytosis due to isoniazid, an uncommon cause of thrombocytopenia that physicians should be aware exists.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.6520-20