Erol ÇAKMAK, Hilmi ATASEVEN, Özlem YÖNEM

Spironolactone induced thrombocytopenia in a patient with liver cirrhosis

İlaça bağlı trombositopenide nadir olmasına rağmen, kanama gibi ölümcül sonuçlara nedenolabileceği için önemlidir. Karaciğer sirozu olan hastalarda asite yönelik diüretik tedavisinde, çoğuzaman sprinolakton kullanılmaktadır. Tiazid grubu diüretiklerde trombositopeni rapor edilmiştir.Ancak Spironalaktona bağlı trombositopeni oldukça nadir görülmektedir. Karaciğer siroz tanısıkonulan asitli hastamızda sprinolakton tedavisi başladıktan yaklaşık iki hafta sonra şiddetlitrombositopeni gelişmesi üzerine sunduk.

Karaciğer sirozlu hastada sp rinolaktona bağlı trombositopeni

Although it is rare, drug-induced thrombocytopenia is important since it may cause fatal resultslike bleeding. Mostly spironolactone is used for ascites palliation in the cirrhotic patients.Thrombocytopenia has been reported with thiazide group of diuretics. But thrombocytopeniacaused by spironolactone is rarely seen. We presented our patient with ascites diagnosed as livercirrhosis that developed severe thrombocytopenia after receiving two weeks of spironolactonetreatment.

PDF

___

1. Hou W, Sanyal AJ. Ascites: diagnosis and management. Med Clin North Am. 2009; 93: 801-17.
2. Warkentin TE. Thrombocytopenia due to platelet destruction and hypersplenism. In: Hoffman R, Benz EJ Jr, Shattil SJ, Furie B, Cohen HJ, Silberstein LE, McGlave P. Hematology: basic principles and practice. 5th ed. Philadelphia: Elsevier, 2008: 2113-31.
3. Aster RH, Curtis BR, McFarland JG, Bougie DW. Drug-induced immune thrombocytopenia: pathogenesis, diagnosis, and management. J Thromb Haemost 2009; 7: 911-8.
4. Pedersen-Bjergaard U, Andersen M, Hansen PB. Drug-induced thrombocytopenia: clinical data on 309 cases and the effect of corticosteroid therapy. Eur J Clin Pharmacol 1997; 52: 183-9.
5. Aster RH, Bougie DW. Drug-induced immune thrombocytopenia. N Engl J Med. 2007; 357: 580-7.
6. George JN, Aster RH. Drug-induced thrombocytopenia: pathogenesis, evaluation, and management. Hematology Am Soc Hematol Educ Program 2009: 153-8.
7. George JN, Raskob GE, Shah SR, Rizvi MA, Hamilton SA, Osborne S, Vondracek T. Drug-induced thrombocytopenia: a systematic review of published case reports. Ann Intern Med 1998; 129: 886-90.