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Updated: Oct 31, 2025

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Roxithromycin-Associated Acute Thrombocytopenia.

Marco Rossi1, Matteo Capecchi1, Pietro E Lazzerini1

  • 1Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, Siena, Italy.

The American Journal of Case Reports
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Summary
This summary is machine-generated.

Roxithromycin, a macrolide antibiotic, can cause acute autoimmune thrombocytopenia. This case report details a patient who recovered after treatment, highlighting the need for clinical consideration of this drug-induced condition.

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Area of Science:

  • Pharmacology
  • Hematology
  • Immunology

Background:

  • Macrolide antimicrobials like azithromycin and clarithromycin have been linked to thrombocytopenia.
  • Existing drug monitoring databases report numerous cases of roxithromycin-associated thrombocytopenia.

Observation:

  • A 78-year-old woman developed petechial lesions, hematomas, and purpuric macules after a roxithromycin course.
  • She presented with severe thrombocytopenia (3000/mL), elevated neutrophils, and lactate dehydrogenase.
  • Autoimmune, viral, lymphoproliferative, and neoplastic causes were excluded through extensive testing.

Findings:

  • This case represents the first reported instance of roxithromycin-induced acute autoimmune thrombocytopenia.
  • The patient's platelet count normalized after treatment with intravenous methylprednisolone and intravenous immunoglobulin therapy.

Implications:

  • Clinicians should consider roxithromycin as a potential cause of drug-induced thrombocytopenia.
  • Early recognition and management can lead to favorable patient outcomes.