Drug-induced Thrombocytopenia

by Carlo Raj, MD

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    00:01 Drug-induced thrombocytopenia.

    00:02 If you missed our discussion on heparin, please make sure that you refer to our hematology hemodynamic pharmacology where I talked about in great detail the possibility when given heparin at the site of injection where there's a possibility in sub-set of population in which may then activate the platelet via platelet factor IV.

    00:21 And by doing so, you may then form a thrombi formation and result in thrombocytopenia.

    00:25 Other causes, quinidine class 1A sodium-channel blocker, sulphas, methyldopa.

    00:32 That'll be in alpha 2 agonist that you may then give a pregnant lady who has hypertension prior, was on ACE inhibitor, obviously, needs to remove that, right? Because ACE inhibitor will kill the kidneys of the fetus or teratogen.

    00:45 And unfortunate the patient may then develop thrombocytopenia.

    00:50 Also penicillins and also thiazide diuretics.

    00:55 HIV-associated thrombocytopenia.

    01:00 This is important.

    01:01 So now you have antibodies formed against HIV antigen.

    01:05 The gp120 cross-react with the platelet surface antigen.

    01:11 In other words, we have example of molecular mimicry of IIb/IIIa.

    01:15 Unbelievable.

    01:17 And now what happens is the antibodies bind to the platelet which are then cleared by the spleen.

    01:22 The particular antigen or chemokine that you wanna know that allows for entry of HIV in the platelet, if you remember from microbiology it's called CXCR4.

    01:34 Keep that in mind please.

    01:36 But at this point, in pathology with HIV, take a look at molecular mimicry with gp120 if you remember that from your HIV discussion.

    About the Lecture

    The lecture Drug-induced Thrombocytopenia by Carlo Raj, MD is from the course Hemodynamics.

    Author of lecture Drug-induced Thrombocytopenia

     Carlo Raj, MD

    Carlo Raj, MD

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