Rifampicin (also known as rifampin) has been known to decrease the
number of platelets in the blood. I've gathered some information that
should provide some insight into the problem. Please keep in mind that
Google Answers is not a source of authoritative medical advice; the
material I've posted below is strictly informational, and should not
be viewed as a diagnosis nor as a substitute for the services of a
qualified medical professional. For reasons of copyright, I can post
only brief excerpts here; you may want to read some of these pages in
their entirety.
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"What is idiopathic thrombocytopenic purpura (ITP)?
ITP is a blood disorder characterized by an abnormal decrease in the
number of platelets in the blood. Platelets are cells in the blood
that help stop bleeding. A decrease in platelets can result in easy
bruising, bleeding gums, and internal bleeding.
'Idiopathic' means the cause is unknown.
'Thrombocytopenia' means a decreased number of platelets in the blood.
'Purpura' refers to the purple discoloring of the skin, as with a bruise...
Although there is no known cause of ITP and there is no cure, the
prognosis for a child with ITP is very good.
Usually, the body stops making the antibodies that are attacking the
platelets and the disorder resolves on its own. The goal of treatment
is to keep the child's platelets in a safe range until the body
corrects the problem."
Lucille Packard Children's Hospital: Hematology & Blood Disorders
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hematology/bledidio.html
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"ITP (Immune or Idiopathic Thrombocytopenic Purpura) is a bleeding
disorder caused when the body?s defense (immune) system attacks and
destroys healthy blood platelets thinking they are disease-causing
agents that don?t belong in the body.
- Immune (auto immune) - the body attacks itself
- Thrombocytopenic - the blood doesn?t have enough platelets (the
tiny, sticky cells that seal small cuts and wounds by forming a clot
or scab).
- Purpura - bleeding into the skin or bruising.
ITP can be either acute (sudden onset, often temporary) or chronic (long lasting).
Most children (80-90%) have acute ITP. These children usually recover
on their own within a few months whether they receive treatment or
not.
Platelet Disorder Support Association: ITP in Children
http://www.itppeople.com/FAQChildren.htm
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"Rifampin can lower the number of white blood cells in your blood
temporarily, increasing the chance of getting an infection. It can
also lower the number of platelets, which are necessary for proper
blood clotting."
HealthTouch Online: Rifampin
http://www.healthtouch.com/bin/EContent_HT/drugShowLfts.asp?fname=usp0152.htm&title=Rifampicin&cid=HT
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"Because ITP in children generally resolves on its own, your
hematologist may recommend your child receives no treatment other than
a weekly or biweekly blood test to monitor their platelet levels. As
soon as a recovery of platelet levels is detected the interval between
blood tests will be lengthened, but your child will still be monitored
until the level returns to normal, and is stable. If treatment is
recommended the following medicines may be used to keep the platelet
count within a safe range until your child?s body recovers on its own.
Prednisone. Prednisone is a synthetic medicine (steroid) similar to
cortisone - a natural substance produced in the body?s adrenal gland.
It is used in the treatment of ITP because it?s been shown to increase
the platelet count while it?s being taken...
Intravenous Gamma Globulin (IVIG). IVIG is a liquid concentrate of
antibodies purified from the plasma (a liquid in the blood that
doesn?t contain red blood cells) of healthy blood donors. It is used
to boost the body?s ability to fight infection. IVIG treatment will
usually result in a rapid (24-48 hours) increase in your child?s
platelet count, but any improvement is generally short-lived.
Treatment may be repeated until the platelet count improves
permanently...
Anti-Rho (D) immune globulin (WinRhoŽ) WinRhoŽ is also a liquid
concentrate of antibodies derived from healthy human plasma. However,
this medicine is targeted against the Rh factor on red blood cells. It
is used to increase your child?s platelet count... Like IVIG, the
response is usually rapid but temporary.
If a hematologist recommends your child is treated with WinRhoŽ, it
will be given by intravenous infusion. The procedure takes about 30-40
minutes and can be done during an outpatient visit."
Platelet Disorder Support Association: ITP in Children
http://www.itppeople.com/FAQChildren.htm
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"Acquired thrombocytopenia may result from the use of certain drugs,
such as quinine, quinidine, rifampin, heparin, nonsteroidal
anti-inflammatory agents, histamine blockers, most chemotherapeutic
agents, allopurinol and alcohol. Impaired production of platelets
usually occurs when stem cells are injured or prevent their
proliferation in bone marrow. Thrombocytopenia may be accompanied by
varying degrees of anemia (low red blood cells) and leukopenia (low
white blood cells). Diagnosis of a platelet production defect is
established by examination of a bone marrow aspirate or biopsy....
Treatment of thrombocytopenia varies according to the cause. If
thrombocytopenia is drug-induced, then removal of the offending agents
should correct the condition. Corticosteroids may be used to increase
platelet production. Lithium carbonate or folate may also be used to
stimulate the bone marrow production of platelets. Platelet
transfusions may be used to stop episodic abnormal bleeding caused by
a low platelet count."
KOMO HealthScout: Thrombocytopenia
http://ww3.komotv.com/global/story.asp?s=1230233
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Here is a list of laboratory tests that are sometimes ordered in cases
of thrombocytopenia. Some of these tests (such as bone marrow
aspiration) are typically only done in acutely ill patients whose
platelet counts have been low for a substantial period of time. Since
most cases of drug-induced thrombocytopenia are self-resolving, your
son's physician is likely to monitor the child's condition with simple
blood tests for a while before ordering tests which are more complex
(and more expensive). In some cases (such as bone marrow aspiration),
medical tests may involve certain dangers, and obviously you don't
want to take such a risk if it is not absolutely necessary.
Complete Blood Cell Count
Peripheral Blood Smear and Mean Platelet Volume
Platelet Survival Studies
Bone Marrow Aspiration or Biopsy
Platelet-Associated Antibody Detection
Serotonin Release
Drug-Specific Platelet Antibodies
Medscape: Evaluation and Management of Drug-Induced Thrombocytopenia
http://www.medscape.com/viewarticle/409521_5
(NOTE: In order to read the Medscape article linked above, you will
need to register with Medscape. This is free, and takes only a few
moments.)
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Google search strategy:
Google Web Search: rifampicin OR rifampin platelets
://www.google.com/search?hl=en&ie=UTF-8&q=rifampicin+OR+rifampin+platelets
Google Web Search: rifampicin OR rifampin thrombocytopenia
://www.google.com/search?hl=en&ie=UTF-8&q=rifampicin+OR+rifampin+thrombocytopenia
Google Web Search: "drug-induced immune thrombocytopenia"
://www.google.com/search?hl=en&ie=UTF-8&q=%22drug-induced+immune+thrombocytopenia
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I hope this is helpful. If anything is unclear, or if a link doesn't
work for you, please request clarification; I'll be glad to offer
further assistance before you rate my answer.
Best wishes,
pinkfreud |
Clarification of Answer by
pinkfreud-ga
on
01 Sep 2004 23:08 PDT
Chris,
Regarding your problem with Medscape, all I can suggest is that you
try again. I have had no difficulties with the site; possibly a server
was down at the time.
Here is a link to Google's cached copy of the Medscape page (this
doesn't require a login or a password):
http://216.239.57.104/search?q=cache:Z_WuvPa8zggJ:www.medscape.com/viewarticle/409521_5
It is, of course, not possible to predict with certainty how long your
son's platelet deficit will last, but the odds are very much in favor
of this being a transient event. Once the drug which precipitated the
platelet reduction is no longer present in the bloodstream, most
children recover rapidly. Over the next few weeks your son's
physicians will be monitoring his platelet count very carefully. This
is not a condition to be taken lightly, but the good news is that in
about 85% of cases, the child recovers completely, and the problem
doesn't return.
~pinkfreud
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