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Trombocitopenia inducida por fármacos

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Trombocitopenia inducida - fármacos; Trombocitopenia inmune - fármacos

Definición

La trombocitopenia es cualquier trastorno en el cual no hay suficientes plaquetas. Estas son elementos en la sangre que la ayudan a coagularse. Un conteo bajo de plaquetas hace que el sangrado sea más probable.

Cuando los medicamentos o fármacos causan un bajo conteo de plaquetas, se denomina trombocitopenia inducida por fármacos.

Causas

La trombocitopenia inducida por fármacos ocurre cuando ciertos medicamentos destruyen las plaquetas o interfieren con la capacidad del cuerpo para producir suficiente cantidad de estas.

Existen dos tipos de trombocitopenia inducida por fármacos: inmunitaria y no inmunitaria.

Si un medicamento provoca que su sistema inmunitario produzca anticuerpos, los cuales buscan y destruyen las plaquetas, la afección se denomina trombocitopenia inmunitaria inducida por fármacos. La heparina, un anticoagulante, probablemente sea la causa más común de este tipo de trombocitopenia.

Si un medicamento impide que la médula ósea produzca suficientes plaquetas, la afección se denomina trombocitopenia no inmunitaria inducida por fármacos. Los fármacos para quimioterapia y un anticonvulsivo llamado ácido valproico pueden llevar a que se presente este problema.

Otros medicamentos que causan trombocitopenia inducida por fármacos incluyen:

Furosemida
Oro, usado para tratar la artritis
Antiinflamatorios no esteroides (AINE)
Penicilina
Quinidina
Quinina
Ranitidina
Sulfamidas
Linezolida y otros antibióticos
Estatinas

Síntomas

La disminución en las plaquetas puede causar:

Sangrado anormal
Sangrado cuando usted se cepilla los dientes
Tendencia a formar hematomas
Manchas rojas puntiformes en la piel (petequias)

Tratamiento

El primer paso es dejar de usar el medicamento que puede estar causando el problema.

Para las personas que tienen sangrado potencialmente mortal, los tratamientos pueden incluir:

Terapia de inmunoglobulina por vía intravenosa (IGIV)
Intercambio del plasma (plasmaféresis)
Transfusiones de plaquetas
Medicamentos corticosteroides

Posibles complicaciones

El sangrado puede ser mortal si ocurre en el cerebro o en ciertos otros órganos.

Una mujer embarazada que tenga anticuerpos contra las plaquetas puede pasarle dichos anticuerpos al bebé en el útero.

Cuándo contactar a un profesional médico

Comuníquese con su proveedor de atención médica si presenta hematomas o sangrado inexplicables, además si está tomando medicamentos como los que se mencionan bajo la sección de causas.

Referencias

Abrams CS. Thrombocytopenia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 158.

Warkentin TE. Thrombocytopenia caused by hypersplenism, platelet destruction, or surgery/hemodilution. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 130.

Programe una cita

Actualizado : 4/18/2023

Versión en inglés revisada por : John Roberts, MD, Professor of Internal Medicine (Medical Oncology), Yale Cancer Center, New Haven, CT. He is board certified in Internal Medicine, Medical Oncology, Pediatrics, Hospice and Palliative Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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