title: A case of acute and severe thrombocytopenia due to readministration of rifampicin.
abstract: A 49-year-old-woman was diagnosed with tuberculosis of the left humerus. She had received treatment, including rifampicin, for tuberculosis 17 years previously. Treatment was begun with isoniazid, rifampicin, ethambutol, and pyrazinamide, but these were discontinued because of mild neutropenia and thrombocytopenia 2 weeks posttreatment. Rifampicin and ethambutol were readministered after a 4-day interruption; however, generalized purpura appeared several hours later. By the next day, her platelet count was reduced from 160 × 10(3) to 3 × 10(3)/μl. The patient improved rapidly after platelet transfusion and steroid treatment. Readministration of drugs other than rifampicin did not induce thrombocytopenia; therefore, thrombocytopenia was likely due to rifampicin.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Toneyama National Hospital, 5-1-1 Toneyama, Toyonaka, Osaka, 560-8552, Japan. mmori@toneyama.go.jp
authors.forename: Masahide
authors.initials: M
authors.lastname: Mori
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Izawa
authors.forename: Takeya
authors.initials: T
authors.lastname: Fujikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uenami
authors.forename: Teppei
authors.initials: T
authors.lastname: Sugano
authors.forename: Sin-ichi
authors.initials: S
authors.lastname: Kagami
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Namba
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yano
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yoneda
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitada
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kimura
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yokota
authors.forename: Ryoji
authors.initials: R
authors.lastname: Maekura
mesh_terms: D000208:Acute Disease; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004977:Ethambutol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006811:Humerus / Q000382:microbiology; D008875:Middle Aged; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects*; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000209:etiology* / Q000503:physiopathology; D014394:Tuberculosis, Osteoarticular / Q000150:complications* / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D004977:Ethambutol; D012293:Rifampin