title: Drug-induced thrombotic microangiopathy: a systematic review of published reports.
abstract: Many patients with syndromes of thrombotic microangiopathy (TMA), including thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome, have been reported to have a drug-induced etiology, and many different drugs have been suspected as a cause of TMA. We established criteria to assess the strength of evidence for a causal association of a drug with TMA and systematically searched for all published reports of drug-induced TMA. We identified 1569 articles: 604 were retrieved for review, 344 reported evaluable data for 586 individual patients, 43 reported evaluable data on 46 patient groups. Seventy-eight drugs were described; 22 had evidence supporting a definite causal association with TMA. Three drugs accounted for 61 of the 104 patient reports with definite evidence (quinine, 34; cyclosporine, 15; tacrolimus, 12). Twenty additional drugs had evidence supporting a probable association with TMA. These criteria and data can provide support for clinicians evaluating patients with suspected TMA.
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, and.
authors.forename: Zayd L
authors.initials: ZL
authors.lastname: Al-Nouri
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, and.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Reese
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, and.
authors.forename: Deirdra R
authors.initials: DR
authors.lastname: Terrell
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, and.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Vesely
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, and Hematology-Oncology Section, Department of Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: James N
authors.initials: JN
authors.lastname: George
mesh_terms: D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced*; D006801:Humans; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced*