WMJ : official publication of the State Medical Society of Wisconsin · 2026
Drug-Induced Thrombocytopenia in an Immunosuppressed Renal Transplant Recipient: A Diagnostic and Therapeutic Challenge.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Abbas Mureed, Shafi Hasaan Salman, Sohail Muhammad Talha, Ud Din Mobeen
Аннотация
INTRODUCTION: Drug-induced thrombocytopenia (DITP) is a rare but life-threatening disorder, particularly in immunosuppressed patients; it can occur via immune and nonimmune mechanisms. β-lactam antibiotics are infrequently known to cause immune DITP.
CASE PRESENTATION: We present the case of a 30-year-old woman with a history of renal transplantation who developed severe thrombocytopenia while receiving ganciclovir for cytomegalovirus, and meropenem and cefoperazone/sulbactam for sepsis. Despite discontinuing ganciclovir, she developed thrombocytopenia, which worsened upon switching to cefoperazone. Her platelet count improved only after discontinuing both β-lactam antibiotics and the administration of eltrombopag.
DISCUSSION: While ganciclovir is a well-known myelosuppressive agent, β-lactam antibiotics such as meropenem and cefoperazone have also been implicated in DITP, particularly via immune-mediated mechanisms. Similar case reports are limited, especially involving immunosuppressed patients requiring complex antimicrobial regimens.
CONCLUSIONS: Clinicians should monitor patients receiving antibiotics for DITP, particularly those on immunosuppressive therapy. This case underscores the need for close monitoring, early drug discontinuation, and consideration of thrombopoietin receptor agents in severe cases of DITP.
CASE PRESENTATION: We present the case of a 30-year-old woman with a history of renal transplantation who developed severe thrombocytopenia while receiving ganciclovir for cytomegalovirus, and meropenem and cefoperazone/sulbactam for sepsis. Despite discontinuing ganciclovir, she developed thrombocytopenia, which worsened upon switching to cefoperazone. Her platelet count improved only after discontinuing both β-lactam antibiotics and the administration of eltrombopag.
DISCUSSION: While ganciclovir is a well-known myelosuppressive agent, β-lactam antibiotics such as meropenem and cefoperazone have also been implicated in DITP, particularly via immune-mediated mechanisms. Similar case reports are limited, especially involving immunosuppressed patients requiring complex antimicrobial regimens.
CONCLUSIONS: Clinicians should monitor patients receiving antibiotics for DITP, particularly those on immunosuppressive therapy. This case underscores the need for close monitoring, early drug discontinuation, and consideration of thrombopoietin receptor agents in severe cases of DITP.