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Anti-tubercular therapy (ATT) induced thrombocytopenia: A systematic review
A Kaur1, R K Bhandari1, R Rohilla2
1Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
The Indian Journal of Tuberculosis
|November 15, 2023
Summary
Antitubercular therapy (ATT) can cause serious, life-threatening thrombocytopenia, primarily linked to rifampicin. Prompt recognition and management are crucial for patient recovery.
Area of Science:
- Pharmacovigilance
- Hematology
- Infectious Diseases
Background:
- Drug-induced thrombocytopenia is a recognized adverse event.
- Antitubercular therapy (ATT) is an uncommon but significant cause of thrombocytopenia.
- This review focuses on thrombocytopenia induced by first-line ATT drugs: isoniazid, rifampicin, pyrazinamide, and ethambutol.
Approach:
- Systematic review of case reports, case series, and letters to the editor from 1970-2021.
- Searched databases including Pubmed/MEDLINE, Ovid, and EMBASE.
- Adhered to PRISMA guidelines for systematic reviews.
Key Points:
- Rifampicin was implicated in 65% of ATT-induced thrombocytopenia cases.
- A median platelet count drop to 20,000/mm³ was observed.
- Anti-rifampicin antibodies and anti-dsDNA positivity were noted in some cases.
Conclusions:
- ATT-induced thrombocytopenia can be severe, necessitating hospitalization.
- Early clinical awareness and appropriate management strategies are vital.
- This review offers a comprehensive overview for managing ATT-induced thrombocytopenia.
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