혈소판 Glycoprotein Ib/IX 및 Ⅱb/Ⅲa에 특이한 항체를 보인 Rifampin에 의한 혈소판 감소증 1례

Abstract

Rifampin is sometimes associated with hematologic complications such as hemolytic anemia or thrombocytopenia. Patients with drug-induced thrombocytopenia develop a drug dependent antibody that binds to platelets in the presence of the drug causing platelet clearance. It has been previously proposed that the antibody binds the drug, resulting in an immune complex that is then adsorbed onto platelets. However, it has been recently known that drug-dependent antibodies bind to one or more of the platelet membrane glycoprotein Ib, lIb,IIIa, and IX. We, hereby, report a case of rifampin-induced thrombocytopenia in which drug-dependent antibody specific for platelet glycoprotein Ib/IX and IIb/IIIa was demonstrated by modified antigen capture ELISA method. The case was a 37 year-old female who had had pulmonary tuberculosis and taken antituberculous regimen including rifampin. Intermittent epistaxis appeared 10 days after treaolent with rifampin. She was admitted to hospital due to gingival bleeding for 3 days and menorrhagia for 2 days. On admission, her platelet count was dropped to 7,000/μL.