Department of Infection Control Science, Graduate School of Medicine, Osaka City University, Japan.
Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan.
Intern Med. 2021 Nov 15;60(22):3639-3643. doi: 10.2169/internalmedicine.6520-20. Epub 2021 May 29.
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.
药物性血小板减少症是通过免疫介导的血小板破坏引起的，在结核病治疗期间其管理具有挑战性。虽然利福平是最常见引起血小板减少症的药物，但异烟肼也可引起血小板减少症。在此，我们报告了一例在结核病治疗期间发生血小板减少症的 75 岁男性。血小板相关免疫球蛋白 G 和异烟肼药物诱导的淋巴细胞刺激试验阳性；未发现其他引起血小板减少症的原因。该患者被诊断为异烟肼诱导的免疫性血小板减少症，停药后血小板计数恢复正常。我们描述了异烟肼引起血小板增多的免疫学机制，这是一种不常见的引起血小板减少症的原因，医生应该知道其存在。
