Вот фрагмент критериев, когда можно считать, что меж назначением лекарства и тромбоцитопенией имеется причинно-следственная связь:
To help establish the likelihood that a particular drug was the cause of the thrombocytopenia, several clinical scoring systems have been developed. In 1982 Hackett et al proposed the following criteria:
(1) Thrombocytopenia developed while the patient is taking the drug, resolved once the drug is stopped and did not recur while the patient was off the drug;
(2) other causes of thrombocytopenia were excluded;
(3) the thrombocytopenia recurred upon re-administration of the drug; and
(4) an in vitro test for drug-dependent platelet antibodies was positive [48].
A positive re-challenge or positive laboratory test was sufficient to confirm the diagnosis.
очень часто многие врачи считают, что наличие только первого критерия достаточно для диагноза - цитопения развилась, пока пациент принимал лекарство, и проходит, когда он перестает его принимать...
PS. еще бывает псевдотромбоцитопения (слипание тромбоцитов в ЭДТА-пробирке) на фоне назначения антибиотиков:
A 70 year-old woman was prescribed of levofloxacin and ceftriaxone for acute bronchitis. On the seventh day of administration she was hospitalized with a dry cough and a decreased platelet count (21 x 10(3)/microliter). However, bleeding tendency was not seen. So, we changed anticoagulants with citric acid and heparin from EDTA, and measured platelet count because we suspected pseudothrombocytopenia (PTCP), then platelet count became elevated (respectively, 125 x 10(3)/microliter and 150 x 10(3)/microliter). In addition, platelet associated IgG increased to 309.3 ng/10(7) cells. Based on drug lymphocyte stimulation test, she was diagnosed as having antibiotic-induced PTCP, especially as she had no history of thrombocytopenia. PTCP should be considered when thrombocytopenia occurs during antibiotic treatment
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