*2.3.3 Clinical manifestation*


*Drug Induced Hematological Disorders: An Undiscussed Stigma DOI: http://dx.doi.org/10.5772/intechopen.109533*


### **2.4 Drug-induced thrombocytopenia**

A disorder known as thrombocytopenia occurs when there are not enough platelets in the blood [29–31]. Blood cells called platelets aid in blood clotting. Bleeding risk is increased by a low platelet count. When thrombocytopenia is present, the platelet count falls below 104 cells/mm3 or falls below 50% of the normal level. About 10 cases/105 people are affected by drug-induced thrombocytopenia per year. Except for cases linked to heparin, none of the numerous epidemiological studies have been reported. Find patient-specific risk factors for medication-induced thrombocytopenia that do not just involve exposure to drug classes.

## *2.4.1 Mechanism involved or pathophysiology of the drug-induced thrombocytopenia anemia*

DITP is a distinctive immune-mediated reaction. Medication-dependent antibodies are a rare family of antibodies that bind securely to platelet surface glycoprotein epitopes only when a sensitizing drug is present. Drug-dependent antibodies are very sensitive to the chemical makeup of drugs. According to this hypothesis, medicines bind non-covalently and reversibly to antibodies as well as platelets, generally at locations on GP IIb-IIIa and/or GP Ib-V-IX. The resulting "sandwich" (seen in **Figure 2**) encourages the development of strong interactions between the antibody and platelet epitopes. The Fab domains' capacity to identify medicines bound to platelet epitopes is used to select the antibodies that are produced because of exposure to sensitizers. Antiplatelet antibodies that are dependent on a medicine typically start to show up 1 to 2 weeks after first exposure. Drug-dependent antibodies may also develop following prolonged, irregular drug use. Unlike neutrophils and erythrocytes, platelets are significantly more frequently the target of drug-dependent antibodies for unexplained reasons.

**Figure 2.** *Drug-dependent model with specific affinity with thrombocytes.*
