title: Severe thrombocytopenia caused by digitoxin intoxication in a patient with heart failure associated with Sjögren's syndrome.
abstract: Congestive heart failure (CHF) related to Sjögren's syndrome is extremely rare. This report concerns a patient who presented with CHF and severe thrombocytopenia (5,000/microl). Serum concentrations of K, Mg and digitoxin were 3.2mmol/L, 1.4mg/L and 57.2ng/ml, respectively. Digitoxin intoxication was evident, seemingly evoked by hypokalemia, hypomagnesemia, hepatorenal dysfunction and hypothyroidism. The severe thrombocytopenia was considered to have been caused by this intoxication, as it disappeared soon after the digitoxin was discontinued and potassium was supplemented.
authors.affiliation: The First Department of Internal Medicine, Kyushu University School of Medicine, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Haro
authors.forename: E
authors.initials: E
authors.lastname: Shimoike
authors.forename: T
authors.initials: T
authors.lastname: Horiuchi
authors.forename: T
authors.initials: T
authors.lastname: Maruyama
authors.forename: Y
authors.initials: Y
authors.lastname: Niho
mesh_terms: D002316:Cardiotonic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004074:Digitoxin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D012859:Sjogren's Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D002316:Cardiotonic Agents; D004074:Digitoxin