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[Thrombocytopenia caused by digitoxin overdose]
J P Gouëllo1, J Victor, A Tadéi
1Service de cardiologie, CHRU, Angers.
Abstract:
The authors report a new case of digitoxin-related thrombocytopenia. It involved a patient hospitalised for torsades de pointe in whom blood digitoxin was 85 micromols/l on admission. This rare complication progressed to a satisfactory conclusion in seven days. The mechanism is immuno-allergic and/or toxic since thrombocytopenia occurs only following therapeutic overdose. The prognosis is determined by the cardiac arrhythmia rather than the hemostasis abnormality. Treatment is symptomatic and should include the withdrawal of digitoxin which can be replaced by digoxin. Oral activated charcoal decreases the plasma half-life by blocking the enterohepatic cycle and is hence recommended in this situation.
Insights
This case study highlights digitoxin-induced thrombocytopenia, a rare complication of therapeutic overdose. Prompt withdrawal of digitoxin and supportive care led to a full recovery within seven days.
Area of Science:
- Cardiology
- Hematology
- Clinical Toxicology
Background:
- Digitoxin is a cardiac glycoside used for heart failure.
- Thrombocytopenia, a decrease in platelet count, can be a rare adverse effect.
- Torsades de pointes is a specific type of cardiac arrhythmia.