SummaryWhat is known and objective: Fluoroquinolone-induced immune-mediated thrombocytopenia is uncommon, and no reports of cross-reactivity among fluoroquinolones exist. Here, we describe a case of ciprofloxacin-induced immune thrombocytopenia with no cross-reactivity with gemifloxacin.
Case description:A 77-year-old woman showed profound thrombocytopenia immediately after two ciprofloxacin injections for pneumonia. Platelet counts recovered rapidly after ciprofloxacin discontinuation. She had experienced thrombocytopenia after ciprofloxacin administration 4 years earlier, which was assumed to be ciprofloxacininduced immune-related. Interestingly, no thrombocytopenia occurred following the subsequent exposure to another fluoroquinolone, gemifloxacin.
What is new and conclusion:No cross-reactivity occurred between ciprofloxacin and gemifloxacin in this fluoroquinolone-induced immune thrombocytopenia case.
K E Y W O R D Sciprofloxacin, cross-reactivity, drug-induced immune thrombocytopenia, gemifloxacin
| WHAT IS KNOWN AND OBJECTIVEAlthough drug-induced thrombocytopenia is a common clinical disorder, severe thrombocytopenia (platelet count <50 000/μL) may lead to serious complications. Until recently, only a few cases of fluoroquinolone-induced thrombocytopenia have been reported. 6-13 However, a study has shown a correlation between thrombocytopenia and fluoroquinolone in intensive care unit patients. 14 In addition, some cases of thrombotic thrombocytopenic purpura and DITP associated with fluoroquinolones have been reported. 9,15 The structural similarities between quinine and fluoroquinolones could explain the DITP associated with the latter.
13Nevertheless, no cross-reactivity between fluoroquinolones has been reported in DITP induction. Here, we described a case of ciprofloxacininduced DITP, which was not cross-reactive with gemifloxacin.
