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Transfusionsmedizin 2025; 15(02): 73-81
DOI: 10.1055/a-2500-8873
Übersicht

Medikament-induzierte Thrombozytopenie

Drug-induced Thrombocytopenia
Günalp Uzun
1   Zentrum für Klinische Transfusionsmedizin Tübingen gemeinnützige GmbH, Tübingen
2   Institut für Klinische und Experimentelle Transfusionsmedizin, Eberhard Karls Universität Tübingen und Universitätsklinikum Tübingen, Tübingen
,
Ulrich J. Sachs
3   Zentrum für Transfusionsmedizin und Hämotherapie an beiden Standorten, Universitätsklinikum Gießen und Marburg (UKGM), mit der Sektion Hämostaseologie am Standort Gießen
4   Institut für Klinische Immunologie, Transfusionsmedizin und Hämostaseologie der Justus-Liebig-Universität Gießen
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Zusammenfassung

Unter medikament-induzierter Thrombozytopenie (DITP) wird die immunvermittelte Thrombozytopenie durch die Bildung medikamenten-abhängiger Antikörper gegen Thrombozyten verstanden. Unterschiedliche pathophysiologische Erklärungsansätze wurden beschrieben. Klinisch kommt es innerhalb von 14 Tagen nach der Einnahme eines neuen Medikaments zu einer raschen Abnahme der Thrombozytenzahlen, meist unter 10 G/l, mit klinischen Blutungszeichen. Die Diagnose hängt wesentlich von der zeitlichen Übereinstimmung zwischen der Verabreichung des Medikaments und dem Auftreten der Thrombozytopenie ab. Labordiagnostik der DITP ist möglich, aber nur der positive Labortest ist klinisch hilfreich. Entscheidende therapeutische Maßnahme ist das sofortige Absetzen des verdächtigen Wirkstoffs. Dies führt typischerweise zu einer Erholung der Thrombozytenzahlen innerhalb weniger Tage. Bei schweren Verlaufsformen sind Thrombozytentransfusionen Therapie der 1. Wahl. Die Prognose ist günstig. Eine Re-Exposition gegenüber dem auslösenden Wirkstoff muss vermieden werden.

Abstract

Drug-induced thrombocytopenia (DITP) refers to immune-mediated thrombocytopenia caused by the formation of drug-dependent antibodies against platelets. Different pathophysiological explanations have been described. Clinically, within 14 days of taking a new drug, there is a rapid decrease in platelet counts, usually below 10 G/l, with clinical signs of bleeding. The diagnosis depends largely on the coincidence in time between the administration of the drug and the occurrence of thrombocytopenia. Laboratory diagnosis of DITP is possible, but only the positive laboratory test is clinically helpful. The decisive therapeutic measure is the immediate discontinuation of the suspected drug. This typically leads to a recovery of the platelet count within a few days. In severe cases, platelet transfusions are the treatment of choice. The prognosis is favorable. Re-exposure to the triggering agent must be avoided.

Schlüsselwörter

Thrombozytopenie - medikament-abhängig - Diagnostik - Therapie

Keywords

thrombocytopenia - drug-dependent - diagnostic approach - therapy


Publication History

Article published online:
14 May 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
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