Many reports of drug-induced thrombocytopenia do not provide evidence supporting a definite or probable causal relation between the disease and the drug. Future patient case reports should incorporate standard criteria to clearly establish the etiologic role of the drug.

Many drugs can induce thrombocytopenia mediated by drug-dependent antiplatelet antibodies. Recent studies have documented specific epitopes for drug-dependent antibody binding on glycoprotein Ib-IX, glycoprotein IIb-IIIa, and platelet-endothelial cell adhesion molecule-1. Molecular identification of antibody binding sites may help to identify susceptible individuals. Management of patients with unexpected thrombocytopenia who are taking multiple drugs remains a difficult clinical problem. A recent systematic review of all published case reports of drug-induced thrombocytopenia ranks drugs according to the strength of clinical evidence for a causal relation to thrombocytopenia. This database is available online at http://moon.ouhsc.edu/jgeorge.

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