Drug-associated disease: hematologic dysfunction

Crit Care Clin. 2006 Apr;22(2):347-55, viii. doi: 10.1016/j.ccc.2006.02.002.

Abstract

Hematologic dysfunction, including thrombocytopenia, anemia, neutropenia, thromboses, and coagulopathy, occur commonly during critical illnesses. A major challenge is to identify drug-induced causes of hematologic dysfunction. Given the wide variety of drug-induced hematologic effects, clinicians always should consider any concomitant drugs in the differential diagnosis of acquired hematologic dysfunction. The most severe effects include drug-induced aplastic anemia, heparin-induced thrombocytopenia, and drug-induced thrombotic microangiopathy. Certain drugs are associated with multiple hematologic effects. For example, cisplatin can cause hemolytic uremia syndrome and erythropoietin deficiency, and quinine can precipitate immune-mediated thrombocytopenia, immune-mediated thrombocytopenia, and thrombotic microangiopathy.

Publication types

  • Review

MeSH terms

  • Anemia, Aplastic / chemically induced*
  • Anticoagulants / adverse effects*
  • Erythropoietin / blood
  • Erythropoietin / deficiency
  • Hematologic Diseases / chemically induced*
  • Hematologic Diseases / immunology
  • Hematologic Diseases / physiopathology
  • Heparin / adverse effects*
  • Humans
  • Methyltransferases / deficiency
  • Severity of Illness Index
  • Thrombocytopenia / chemically induced*

Substances

  • Anticoagulants
  • Erythropoietin
  • Heparin
  • Methyltransferases
  • thiopurine methyltransferase