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[Digitoxin-induced thrombocytopenia]

M Gschwantler1, W Gulz, E Brownstone

  • 14. Medizinische Abteilung, Krankenanstalt Rudolfstiftung, Wien.

Wiener Klinische Wochenschrift
|January 1, 1993
PubMed
Summary
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Digitalis intoxication in an elderly woman caused heart failure and thrombocytopenia. Treatment with cholestyramine accelerated digitoxin excretion, leading to recovery of platelet counts.

Area of Science:

  • Cardiology
  • Clinical Pharmacology

Background:

  • Elderly patients are susceptible to adverse drug reactions.
  • Digitoxin, a cardiac glycoside, has a narrow therapeutic index.

Observation:

  • An 82-year-old woman presented with heart failure, vomiting, and abdominal pain after three months of digitoxin treatment.
  • ECG revealed sinus bradycardia with sinoatrial block.
  • Marked thrombocytopenia (25,000/microliters) was observed.

Findings:

  • Suspected digitalis intoxication confirmed by a high digitoxin level (65.23 ng/ml).
  • Cholestyramine treatment facilitated intestinal digitoxin excretion.
  • Platelet count normalized within 12 days of digitoxin discontinuation.

Implications:

Related Experiment Videos

  • This case highlights the importance of monitoring digitoxin levels in elderly patients.
  • Cholestyramine can be an effective non-antibody treatment for digitoxin toxicity.
  • Prompt recognition and management are crucial for favorable outcomes in digitalis intoxication.