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Thank you for attending THSNA 2026. The virtual meeting is now closed.
Thank you for attending THSNA 2026. The virtual meeting is now closed.
Presentation Details
| Drug-Induced Thrombocytopenia from Proton Pump Inhibitors and H₂ Blockers: A Systematic Review and Comparative Analysis of Published Case Reports Swapnil Surpur, Himani Mongia, Sameer Bhimani, Mohamed Ahmed, Teodor Lazic, James Cortese. The Wright Center for GME, Scranton, PA, USA |
Abstract
Background: Drug-induced thrombocytopenia (DITP) linked to proton-pump inhibitors (PPIs) and histamine-2 receptor antagonists (H₂RAs) is described mainly in single-patient reports. We synthesized published case reports and case series across major databases to compare latency to thrombocytopenia, recovery after drug cessation, bleeding manifestations, and ICU association for PPIs versus H₂RAs. Methods: Systematic searches of PubMed, PMC, Google Scholar and journal archives through September 2025 identified case reports/series with explicit time-to-onset and time-to-recovery. Representative PPI reports (pantoprazole, lansoprazole, omeprazole/esomeprazole) and classical H₂RA reports (cimetidine, ranitidine, famotidine) were abstracted for onset (days), recovery (days), bleeding and ICU status. Key mechanistic reports (drug-dependent antibodies) were reviewed. Results: Twenty-three case reports/series met inclusion. For PPIs (n≈13 reports) median onset was 3 days (IQR 2–5) and median recovery 6 days (IQR 3–10) after discontinuation. For H₂RAs (n≈10 reports) median onset was 4 days (IQR 1–7) and median recovery 8 days (IQR 5–11). Bleeding manifestations were more frequent with PPIs (7/13, 54%) than H₂RAs (2/10, 20%; p = 0.046). ICU involvement was identified in 5/13 (38%) of PPI cases—predominantly lansoprazole and pantoprazole—versus 1/10 (10%) of H₂RA cases (Fisher p = 0.18), suggesting a non-significant but clinically relevant trend toward greater PPI-associated thrombocytopenia in critically ill patients.. All responsive cases described platelet normalization within 2 weeks after drug withdrawal. Conclusions: Case-level evidence indicates both PPIs and H₂RAs can cause abrupt, reversible thrombocytopenia with onset within days and recovery within 1–2 weeks; PPI reports show a trend toward earlier onset and higher bleeding documentation. Findings are limited by reporting bias and small numbers; prospective pharmacovigilance and mechanistic testing are needed to confirm class-specific risks.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.