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Comments, Opinions, and Brief Case Reports
March 24, 2003

Thrombocytopenia Associated With Levodopa Treatment

Arch Intern Med. 2003;163(6):735-736. doi:10.1001/archinte.163.6.735

In a recently released review of published case reports, excluding those related to heparin administration, 98 drugs were listed with a definite or probable causal role for drug-induced thrombocytopenia. The most commonly implicated were quinidine, gold salts, and the combination drug trimethoprim-sulfamethoxazole.1-3 Drug-induced thrombocytopenia is mostly produced by the autoimmune mechanism.4 A short-term drug treatment induction period, averaging 14 days, with a short recovery period after withdrawal of drug treatment, averaging 7 days, have been described.2 Although thrombocytopenia can be severe, major bleeding and death have been reported in only 9% and 0.8% of the cases, respectively, we reviewed in the literature.2 We report the case of a patient with severe thrombocytopenia, probably induced by levodopa, a side effect previously reported in only 1 case.5