Nakane Chinatsu, Nishimoto Koji, Kishimoto Ei, Suzuki Kosuke, Nakagawa Emiko, Morikawa Moeko, Murakami Yurina, Aoshima Yoichiro, Matsushima Sayomi, Harada Masanori, Uto Tomohiro, Imokawa Shiro
Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan.
Respir Med Case Rep. 2023 Feb 25;42:101823. doi: 10.1016/j.rmcr.2023.101823. eCollection 2023.
Severe immune thrombocytopenia is a rare side-effect of rifampicin (RFP) and can be life-threatening. Here, we report the case of a 74-year-old male with tuberculous pleurisy who developed severe thrombocytopenia after first exposure to RFP. Platelet count decreased to 1 × 10/μL after 7 days of treatment with RFP, isoniazid, ethambutol, and pyrazinamide. After all the drugs were discontinued, the platelet count recovered. As thrombocytopenia did not occur after re-administration of drugs other than RFP, the patient was diagnosed with RFP-induced thrombocytopenia. Clinicians should be aware that RFP can induce acute and severe thrombocytopenia even without previous exposure to this drug.
严重免疫性血小板减少症是利福平（RFP）一种罕见的副作用，可能危及生命。在此，我们报告一例74岁男性结核性胸膜炎患者，首次接触RFP后出现严重血小板减少症。在用RFP、异烟肼、乙胺丁醇和吡嗪酰胺治疗7天后，血小板计数降至1×10/μL。停用所有药物后，血小板计数恢复。由于再次使用除RFP以外的其他药物后未发生血小板减少症，该患者被诊断为RFP诱导的血小板减少症。临床医生应意识到，即使患者以前未接触过RFP，它也可能诱发急性和严重的血小板减少症。
