Drug-Induced Immune-Mediated Thrombocytopenia — From Purpura to Thrombosis

Abstract

In 1949, Ackroyd reported the abrupt onset of severe thrombocytopenia and purpura in patients receiving the sedative allylisopropylacetylcarbamide (Sedormid).¹ All the patients had taken Sedormid previously and had become sensitized to it. Today, this classic picture of drug-induced, immune-mediated thrombocytopenia is most often caused by quinine in outpatients and by vancomycin in hospitalized patients, as discussed by Von Drygalski et al. in this issue of the Journal (pages 904–910).In 1973, Rhodes, Dixon, and Silver described thrombocytopenia and thrombosis occurring a week after the initiation of heparin therapy and provided evidence of an immune pathogenesis for this complication of heparin . . .