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Acute thrombocytopenic purpura in relation to the use of drugs
DW Kaufman, JP Kelly, CB Johannes, A Sandler, D Harmon, PD Stolley and S Shapiro
Slone Epidemiology Unit, School of Public Health, Boston University School
of Medicine, Brookline, MA.
The relation of acute thrombocytopenic purpura (TP) to the use of drugs was
investigated in a case-control study conducted in eastern Massachusetts,
Rhode Island, and the Philadelphia region; 62 cases over the age of 16
years with acute onset and with a rapid recovery were compared with 2,625
hospital controls. After control for confounding by multiple logistic
regression, use of the following drugs in the week before the onset of
symptoms was significantly associated: trimethoprim/sulfamethoxazole
(relative risk [RR] estimate, 124), quinidine/quinine (101), dipyridamole
(14), sulfonylureas (4.8), and salicylates (2.6). The overall annual
incidence of acute TP was estimated to be 18 cases per million population.
The excess risks for the associated drugs were estimated to be 38 cases per
million users of trimethoprim/sulfamethoxazole per week, 26 per million for
quinidine/quinine, 3.9 per million for dipyridamole, 1.2 per million for
sulfonylureas, and 0.4 per million for salicylates. Associations with
sulfonamides, quinidine/quinine, sulfonylureas, and salicylates have been
previously reported, but the present study has provided the first
quantitative measures of the risk. The association with dipyridamole was
unexpected. In general, despite large RRs, the incidence rates attributable
to the drugs at issue (excess risks) were low, suggesting that TP is not an
important consideration in the use of the various drugs.
Volume 82,
Issue 9,
pp. 2714-2718,
11/01/1993
Copyright © 1993 by The American Society of Hematology
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