Criteria for assessing reports of drug-induced thrombocytopenia and levels of evidence for a causal relationship of the drug to thrombocytopenia

Criteria

1. The candidate drug preceded thrombocytopenia AND recovery from thrombocytopenia was complete and sustained after the drug was discontinued.

2. The candidate drug was the only drug used prior to the onset of thrombocytopenia OR other drugs were continued or reintroduced after discontinuation of the candidate drug with a sustained normal platelet count.

3. Other etiologies for thrombocytopenia were excluded.

4. Re-exposure to the candidate drug resulted in recurrent thrombocytopenia OR drug-dependent, platelet-reactive antibodies were documented.

Level of evidence

Definite: criteria 1, 2, 3, and 4 met

Probable: criteria 1, 2, and 3 met

Possible: criterion 1 met

Unlikely: criterion 1 not met

Refer to UpToDate content on drug-induced thrombocytopenia for further information and a list of drugs implicated in drug-induced immune thrombocytopenia (DITP).

Adapted from:

George JN, Raskob GE, Shah SR, et al. Drug-induced thrombocytopenia: a systematic review of published case reports. Ann Intern Med 1998; 129:886.
Arnold DM, Nazi I, Warkentin TE, et al. Approach to the diagnosis and management of drug-induced immune thrombocytopenia. Transfus Med Rev 2013; 27:137.

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Criteria for assessing reports of drug-induced thrombocytopenia and levels of evidence for a causal relationship of the drug to thrombocytopenia