Treatment options in sulfamethoxazole-trimethoprim-induced thrombocytopenic purpura.
We describe two female patients who had severe sulfamethoxazole-trimethoprim-induced thrombocytopenic purpura. One case occurred shortly after initiating therapy, whereas the other began on the seventh day of treatment. Both patients presented a platelet count below 5,000/microL, extensive purpura, and significant vaginal bleeding. Treatment with systemic corticosteroids resulted in rapid resolution of the thrombocytopenia in the first patient, but had no immediate effect in the other. High-dose intravenous immunoglobulin was effective in correcting the thrombocytopenia in this second instance. Both patients were discharged with a tapering 4-week course of oral prednisone and have remained well since.
Herrington
A
A
College of Pharmacy, University of Kentucky, Department of Medicine, Lexington.
Mahmood
A
A
Berger
R
R
D000328:Adult; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011696:Purpura, Thrombocytopenic / Q000139:chemically induced* / Q000628:therapy*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*
D016756:Immunoglobulins, Intravenous; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011241:Prednisone; D008775:Methylprednisolone