[A severe side effect of antitubercular therapy: pyrazinamide induced thrombocytopenia].

Abstract

The haematological side effects of antitubercular drugs are not well known. We report the observation of a patient who received Rifater for the treatment of pulmonary tuberculosis. After one month of treatment, he developed an acute pulmonary infection, with neutropenia (1218/microl) and thrombocytopenia (109,000/microl), requiring suspension of his antitubercular drugs. After the reintroduction of he again developed thrombocytopenia (6,000/microl) associated with bleeding and required treatment with intravenous immunoglobulin. The introduction of a combination of moxifloxacin, isoniazid, pyrazinamide, and ethambutol was followed by a new relapse of the thrombocytopenia. Responsibility of pyrazinamide was then suspected and later confirmed by the evolution of platelet levels after stopping and reintroducing this antibiotic. This is the third reported case of pyrazinamide induced thrombocytopenia, whose frequency is probably underestimated because of the use of compound treatment.

• Authors: J-B Roseau, H Berard, G N'guyen Huy Thuy, F Rocher, J Legodec, C Chouaid
• Journal: Revue des maladies respiratoires (Rev Mal Respir) Vol. 25 Issue 9 Pg. 1142-4 (Nov 2008) ISSN: 0761-8425 [Print] France
• Vernacular Title: Un effet indésirable grave du traitement antituberculeux: la thrombopénie au pyrazinamide.
• PMID: 19106913 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antitubercular Agents
• Pyrazinamide

Topics

• Aged
• Antitubercular Agents (adverse effects)
• Humans
• Male
• Pyrazinamide (adverse effects)
• Thrombocytopenia (chemically induced)