Related Experiment Videos
[Reversible thrombocytopenia due to digitoxin overdose]
J Krappweis1, G Petereit, K U Schentke
1Klinische Pharmakologie und Therapie, Technische Universität Dresden.
Deutsche Medizinische Wochenschrift (1946)
|December 16, 1994
Summary
High digitoxin levels in a heart failure patient caused severe thrombocytopenia (low platelet count). Discontinuing digitoxin resolved the condition, highlighting the importance of monitoring drug toxicity.
Area of Science:
- Cardiology
- Pharmacology
- Hematology
Background:
- Cardiac glycosides like digitoxin are used for heart failure.
- Therapeutic drug monitoring is crucial due to narrow therapeutic windows.
- Patient presented with gastrointestinal symptoms and was on digitoxin therapy.
Observation:
- A 65-year-old woman with peptic ulcers and heart failure developed nausea and epigastric pain.
- Endoscopy revealed gastric ulcers and erosive gastritis.
- The patient reported increased digitoxin intake for insomnia, leading to supratherapeutic plasma levels.
Findings:
- Initial platelet count was severely low at 40,000/microliter.
- ECG showed no signs of digitalis intoxication despite high digitoxin levels.
- Platelet count normalized to 373,000/microliter after digitoxin withdrawal.
Implications:
- Digitoxin toxicity can manifest as thrombocytopenia, even without overt ECG changes.
- Careful dose management and monitoring are essential for patients on digitoxin.
- This case underscores the need to investigate drug-induced thrombocytopenia in patients with supratherapeutic drug levels.