Immediate posttransplantation cotrimoxazole-induced immune thrombocytopenia.
Drug-induced immune thrombocytopenia (DITP) can be caused by numerous drugs. When this condition develops, platelet destruction results from binding of antibodies to normal platelets only in the presence of a sensitizing drug. A recently proposed model suggests that these drug-dependent antibodies are derived from a pool of naturally occurring antibodies with weak affinity for specific epitopes on certain platelet membrane glycoproteins. We describe here a case of DITP secondary to cotrimoxazole exposure in the immediate posttransplantation phase in a renal transplant recipient. Apart from heparin-induced thrombocytopenia, DITP posttransplantation has to the best of our knowledge never been described, perhaps because of its immune-mediated origin. Our case demonstrates that DITP can occur posttransplantation, that cotrimoxazole due to its intensive use in the transplanted population is one of the most likely causative agents and that a timely recognition and treatment might have important consequences for both graft and patient.
Caluwé
R
R
Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium.
Van Laecke
S
S
Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium.
Emonds
M-P
MP
Laboratory for Histocompatibility and Immunogenetics, HILA Mechelen, Belgium.
Peeters
P
P
Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium.
Vanholder
R
R
Renal Division, Department of Internal Medicine, University Hospital Gent, Belgium.
D000328:Adult; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D013921:Thrombocytopenia / Q000139:chemically induced*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*
D015662:Trimethoprim, Sulfamethoxazole Drug Combination