Severe thrombocytopenia associated with cocaine use

Article Abstract:

Thrombocytopenia, or a reduced quantity of blood platelets, can result in bleeding complications, although life-threatening bleeding is rare. Thrombocytopenia has been reported in intravenous drug users and cocaine users infected with HIV, the human immunodeficiency virus. However, six patients have now been seen with severe, destructive thrombocytopenia, and these cases suggest that the cocaine itself may be responsible for the reduction in platelets. One of the six patients only used cocaine by inhalation. All the patients were found to be negative for antibodies to HIV. The five patients who had used drugs intravenously were tested for the human T-cell lymphotropic virus type I (HTLV-I) and were also found to be negative for this infection. Five of the six patients responded completely to treatment with corticosteroids, suggesting that an immunological process may be involved. The remaining patient responded only partially to corticosteroids but experienced complete recovery of platelet levels after splenectomy, the removal of the spleen. Since all patients were treated and all responded, it is impossible to determine whether the thrombocytopenia associated with cocaine use is self-limiting, and whether it would eventually disappear if the use of the drug were suspended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Cocaine abuse, Cocaine

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Thombotic complications of antithrombotic therapy: a paradox with implications for clinical practice

Article Abstract:

Two serious complications related to the use of the anticoagulant drugs heparin and warfarin could possibly be avoided in the future. Heparin is approved for treatment of blood clots in the deep veins. Rarely, it can result in a serious condition called heparin-induced thrombocytopenia, actually causing clots and reducing the number of platelets in the bloodstream. Warfarin is often administered to combat this complication. It is now suspected that this treatment sometimes leads to venous limb gangrene. Understanding the influences of dosage and the timing of administration could help to prevent these catastrophic complications.

Editorial, Thrombosis, Warfarin

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Delayed-onset heparin-induced thrombocytopenia and thrombosis

Article Abstract:

Some patients can have an adverse reaction to heparin called thrombocytopenia even several days after stopping the treatment. Thrombocytopenia is a decrease in the number of blood platelets, which are essential for blood clot formation.

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