Color Atlas of Hematology - Practical Microscopic and Clinical ...

166Erythrocyte and Thrombocyte AbnormalitiesTable 29Most common triggers of drug-induced immunothrombocytopeniaAnalgesicsAntibioticsAnticonvulsive drugsArsenic, e. g., in waterQuinidineQuinineDigitalis preparationsFurosemideGold saltsHeparin!IsoniazidMethyldopaSpironolactoneTolbutamide“Idiopathic” immunothrombocytopenia. The name is largely historical,because often a trigger is found.➤ Postinfectious = acute form, usually occurs in children after rubella,mumps, or measles.➤ Essential thrombocytopenia, thrombocytopenic purpura (Werlhof disease)Thrombocyte antibodies develop without an identifiable trigger. This isthus a primary autoimmune disease specifically targeting thrombocytes.Secondary immunothrombocytopenias, e.g., in lupus erythematosus andother forms of immune vasculitis, lymphomas, and tuberculosis.Post-transfusion purpura occurs mostly in women about one week after ablood transfusion, often after earlier transfusions or pregnancy.Thrombocytopenia in microangiopathy. This group includes thrombotic–thrombocytopenic purpura (see p. 144) and disseminated intravascularcoagulation.Thrombocytopenia in hypersplenism of whatever etiology.Fig. 59 Continued. c Pseudothrombocytopenia. The thrombocytes are not lying free and scattered around, but agglutinated together, leading to a reading ofthrombocytopenia from the automated blood analyzer. d Giant thrombocyte (aslarge as an erythrocyte) in thrombocytopenia. Döhle-type bluish inclusion (arrow)in the normally granulated segmented neutrophilic granulocyte: May-Hegglinanomaly.