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Volume 357:1869-1871 November 1, 2007 Number 18
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Drug-Induced Immune Thrombocytopenia

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by Aster, R. H.
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To the Editor: In their review of drug-induced immune thrombocytopenia, Aster and Bougie (Aug. 9 issue)1 do not mention an important aspect of drug-induced thrombocytopenia–thrombosis. Glycoprotein IIb/IIIa inhibitors (both oral and intravenous formulations) and bivalirudin are known to cause both significant thrombocytopenia and thrombosis (myocardial infarction and stroke) and are associated with increased mortality.2,3,4 Bivalirudin, a direct thrombin inhibitor increasingly used in the United States for percutaneous coronary interventions (PCI), has been found to induce severe thrombocytopenia (<50,000 platelets per cubic millimeter) in 0.3% of patients undergoing PCI, moderate thrombocytopenia (<100,000 platelets per cubic millimeter) in 2.9% of such patients, . . . [Full Text of this Article]



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