digoxin and Thrombocytopenia

Topics: Cardiotonic Agents; Digoxin; Female; Humans; Male; Middle Aged; Purpura, Thrombocytopenic, Idiopathic; Recurrence; Splenectomy; Thrombocytopenia

As a result of overdosage a 77-year-old patient with heart disease developed digitoxin intoxication, associated with arrhythmias, extracardiac symptoms of intoxication and severe thrombocytopenia. Treatment with digoxin-specific antibody fragments relieved the signs and symptoms of intoxication within a few hours. The rise in platelet count from the pretreatment value of 26 000/mm3 to 47 000 within 12 h and to over 60 000/mm3 within 16 h of starting the antibody infusion may also be attributed to the treatment with antibodies. Such a rapid recovery from digitoxin-induced thrombocytopenia has not hitherto been described. Digoxin-specific antibodies, obtained by immunization of sheep with a digoxin-albumin conjugate, were used to treat intoxication with digitoxin, since cross-reaction had been demonstrated in vitro and in animal experiments. The present paper briefly discusses the mode of action and the general problems relating to the antibody therapy of digitalis poisoning.

Topics: Aged; Animals; Digitoxin; Digoxin; Follow-Up Studies; Heart Failure; Humans; Immunoglobulin Fab Fragments; Immunotherapy; Infusions, Parenteral; Male; Platelet Count; Self Administration; Sheep; Thrombocytopenia

We present two cases in which thrombocytopenia developed during low-dose heparin therapy. They seem to represent the spectrum of heparin-associated thrombocytopenia described by Carreras. Because of the increasing use of low-dose heparin for thromboembolism prophylaxis, and because patient reexposure to heparin is not uncommon, the identification of even a modest fall in platelet count in association with heparin therapy is important.

Topics: Aged; Atrial Fibrillation; Collateral Circulation; Digoxin; Electric Countershock; Female; Heparin; Humans; Platelet Count; Thrombocytopenia; Thrombosis; Time Factors

Topics: Digoxin; Humans; Infant; Male; Thrombocytopenia

A 60-year-old male patient had two episodes of thrombocytopaenia whilst being treated with digoxin, each of them reversible upon withdrawal of the drug. Bone marrow examination was consistent with peripheral platelet destruction as the main mechanism of the thrombocytopaenia. The inhibition of clot retraction test was positive, with a declining titer, after cessation of digoxin therapy, and this plus the finding of circulating immune complexes after incubation of the patient's serum with digoxin established digoxin as the offending agent. It is concluded that digoxin may be a rare cause of drug-induced immune-thrombocytopaenia.

Topics: Digoxin; Drug Hypersensitivity; Humans; Male; Middle Aged; Thrombocytopenia

Topics: Aged; Ajmaline; Aniline Compounds; Arrhythmias, Cardiac; Benzyl Compounds; Bone Marrow Examination; Cell Survival; Chromium Radioisotopes; Clot Retraction; Digoxin; Drug Combinations; Drug Hypersensitivity; Ethylenediamines; Histocytochemistry; Humans; Imidazoles; Male; Megakaryocytes; Phenobarbital; Sparteine; Thrombocytopenia

Topics: Adult; Afibrinogenemia; Blood Cell Count; Blood Platelets; Body Temperature; Chloramphenicol; Digoxin; Disseminated Intravascular Coagulation; Fibrin; Fibrinogen; Heparin; Humans; Hydrocortisone; Male; Penicillins; Rocky Mountain Spotted Fever; Thrombocytopenia

Topics: Acidosis; Alkalosis; Anti-Bacterial Agents; Blood Transfusion; Body Temperature; Digoxin; Diuretics; Drainage; Glucose; Heart Arrest; Heart Defects, Congenital; Humans; Hypoglycemia; Hypoproteinemia; Infant, Newborn; Intubation, Intratracheal; Isoproterenol; Parenteral Nutrition; Positive-Pressure Respiration; Postoperative Care; Serum Albumin; Thrombocytopenia; Water-Electrolyte Balance

Topics: Aged; Agglutinins; Aortic Valve Stenosis; Blood Platelets; Cells, Cultured; Digitoxin; Digoxin; Female; Heart Diseases; Hemagglutination Tests; Humans; Lymphocyte Activation; Lymphocytes; Thrombocytopenia

Topics: Arrhythmias, Cardiac; Clinical Laboratory Techniques; Digoxin; Female; Goiter; Graves Disease; Hepatomegaly; Humans; Hyperthyroidism; Hypoprothrombinemias; Infant; Infant, Newborn; Infant, Newborn, Diseases; Iodides; Liver Diseases; Maternal-Fetal Exchange; Prednisolone; Pregnancy; Pregnancy Complications; Reserpine; Splenomegaly; Thrombocytopenia; Toxicology; Vitamin K

Topics: Bradycardia; Delirium; Digitalis; Digitalis Glycosides; Digitoxin; Digoxin; Gynecomastia; Humans; Lanatosides; Male; Neuritis; Paresthesia; Tachycardia; Thrombocytopenia; Toxicology; Trigeminal Neuralgia; Urticaria