Methylprenisolone drug-induced immune thrombocytopenia ; Thrombopénies immunologiques liées à des anticorps anti-plaquettes méthylprednisolone-dépendants

Introduction: drug-induced immune thrombocytopenia is due to anti-platelet antibodies active only on presence of the suspected treatment. They are usually associated with a unique drug. Materiel and methods: between 2009 and 2017, six adult patients with a suspected methylprednisolone (MP)-induced immune thrombocytopenia for which sera where addressed to the Mondor hospital EFS unit were included. Their medical charts were retrospectively reviewed. Drug-induced anti-platelet antibodies were screened by the MAIPA test and identified by an adsorption-elution method.Results: the six patients presented with acute and profound thrombocytopenia occurring after a MP infusion and resolving in a week. MP-induced antiplatelet antibodies were found in the blood of all the six patients. All had been previously exposed to MP without adverse events. Five out of 6 patients had chemotherapy for neoplasia. Three out of the 5 patients had associated thrombocytopenia induced by oxaliplatin or folinic acid anti-platelets antibodies. Adsorption-elution analysis of 2 patients suggested the presence on 2 different drug-induced anti-platelets antibodies (MP and folinic acid or MP and oxaliplatin). Conclusion: we report 6 cases of MP-induced immune thrombocytopenia. Three of them had associated folinic acid or oxaliplatin-induced thrombocytopenia mediated by different drug-induced anti-platelets antibodies. ; Introduction : les thrombopénies immunologiques liées à des anticorps (Ac) anti-plaquettes médicament-dépendants (TIMD) sont des causes rares de thrombopénies, liées à la présence d’Ac qui, en se fixant sur la membrane plaquettaire uniquement en présence d’un médicament, entraînent leur destruction. Matériels et méthodes : six patients adultes suspects de TIMD à la méthylprednisolone (MP) et dont les sérums ont été adressés au laboratoire de l’EFS de l’hôpital Mondor entre 2009 et 2017, ont été inclus. Leurs dossiers médicaux ont été rétrospectivement analysés et des Ac anti-plaquettes médicament-dépendants ont été recherchés par ...