Tamoxifen-induced immune-mediated platelet destruction. A case report

Tumori. 1993 Jun 30;79(3):231-4. doi: 10.1177/030089169307900316.

Abstract

Drug-induced immunologic thrombocytopenia, a fairly common disorder, is characterized by drug-dependent antiplatelet antibodies that destroy circulating platelets in the presence of the provoking drug or its metabolites. The development of reliable methods for the detection of platelet-bound immunoglobulins causing in vivo platelet destruction, such as the use of monoclonal antibodies tagged with fluorescein and flow cytofluorimetric analysis, has ushered in a new era to differentiate between immune and non-immune thrombocytopenias. A severe thrombocytopenia developed in an elderly female patient treated with tamoxifen, a non-steroidal anti-estrogen drug, after surgery for breast cancer. A tamoxifen-dependent platelet antibody was detected in the patient's serum and linked on the platelet membranes. This antibody reacted only in the presence of the offending drug and showed platelet specificity. Withdrawal of drug restored platelet count to normal levels.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibody Formation
  • Blood Platelets / drug effects
  • Female
  • Flow Cytometry
  • Fluorescent Antibody Technique
  • Humans
  • Tamoxifen / adverse effects*
  • Tamoxifen / immunology
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / immunology

Substances

  • Tamoxifen