A case of severe thrombocytopenia after the first exposure to rifampicin

Chinatsu Nakane; Koji Nishimoto; Ei Kishimoto; Kosuke Suzuki; Emiko Nakagawa; Moeko Morikawa; Yurina Murakami; Yoichiro Aoshima; Sayomi Matsushima; Masanori Harada; Tomohiro Uto; Shiro Imokawa

doi:10.1016/j.rmcr.2023.101823

A case of severe thrombocytopenia after the first exposure to rifampicin

Respir Med Case Rep. 2023 Feb 25:42:101823. doi: 10.1016/j.rmcr.2023.101823. eCollection 2023.

Affiliation

¹ Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan.

Abstract

Severe immune thrombocytopenia is a rare side-effect of rifampicin (RFP) and can be life-threatening. Here, we report the case of a 74-year-old male with tuberculous pleurisy who developed severe thrombocytopenia after first exposure to RFP. Platelet count decreased to 1 × 10³/μL after 7 days of treatment with RFP, isoniazid, ethambutol, and pyrazinamide. After all the drugs were discontinued, the platelet count recovered. As thrombocytopenia did not occur after re-administration of drugs other than RFP, the patient was diagnosed with RFP-induced thrombocytopenia. Clinicians should be aware that RFP can induce acute and severe thrombocytopenia even without previous exposure to this drug.

Keywords: Rifampicin; Thrombocytopenia; Tuberculosis.

Publication types

Case Reports