Muhammad Safwan, Naeem Ammad, Shaukat Amna, Javaid Subas, Alvi Saqib
Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, USA.
Internal Medicine, University at Buffalo, Buffalo, USA.
Cureus. 2020 May 26;12(5):e8293. doi: 10.7759/cureus.8293.
Thrombocytopenia is a common clinical condition, and drug-induced immune thrombocytopenia (DITP) should be considered in hospitalized patients with severe thrombocytopenia who are exposed to new medications. The potential mechanism is described to be drug-triggered antibody-mediated platelet destruction causing petechiae and mucosal bleeding. Severe form of DITP can be refractory to systemic steroids and even intravenous immunoglobulin administration. Such cases usually require splenectomy for definitive treatment. A number of substances including medications, herbal remedies, and even food items have been identified with a definitive or probable causal role in DITP. However, it is rarely reported from locally administered medications such as local anesthetic drugs. We present a unique case of severe DITP from lidocaine that resulted in refractory DITP requiring splenectomy for definitive treatment.
血小板减少症是一种常见的临床病症，对于住院的严重血小板减少且接触了新药物的患者，应考虑药物性免疫性血小板减少症（DITP）。其潜在机制被描述为药物引发的抗体介导的血小板破坏，导致瘀点和黏膜出血。严重的DITP对全身用类固醇甚至静脉注射免疫球蛋白治疗可能无效。此类病例通常需要进行脾切除术以获得确定性治疗。包括药物、草药甚至食品在内的多种物质已被确定在DITP中具有明确或可能的因果关系。然而，局部给药药物如局部麻醉药导致DITP的情况鲜有报道。我们报告了一例由利多卡因引起的严重DITP的独特病例，该病例导致难治性DITP，需要进行脾切除术以获得确定性治疗。
