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Glycoprotein Ib/IX complex is the target in rifampicin‐induced immune thrombocytopenia
Author(s) -
Pereira Jaime,
Hidalgo Patricia,
Ocqueteau Mauricio,
Blacutt Marcelo,
Marchesse Miguel,
Nien Yih,
Letelier Luz,
Mezzano Diego
Publication year - 2000
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2000.02299.x
Subject(s) - immune thrombocytopenia , glycoprotein , immunology , immune system , virology , rifampicin , medicine , platelet , cancer research , biology , microbiology and biotechnology , tuberculosis , pathology
Thrombocytopenia is a major adverse effect of several drug treatments. Rifampicin has been recognized as a cause of immune thrombocytopenia during intermittent high‐dose therapy. We characterized the antibody of a patient who presented with purpura and thrombocytopenia during treatment of tuberculosis with rifampicin. Drug‐dependent binding of the antibody to platelets was demonstrated by flow cytometry. In a glycoprotein‐specific immunoassay, the binding epitope of the IgG antibody was found in the glycoprotein Ib/IX complex, using four different monoclonal antibodies (mAbs) against various epitopes on the GPIb/IX complex, as well as mAbs against GPIIb/IIIa, GPIa/IIa and GPIV. By immunoprecipitation of biotin‐labelled platelets, reactivity of the antibody with GPIb/IX was found only in the presence of the drug. These findings clearly demonstrate that rifampicin induces the formation of drug‐dependent antibodies capable of causing thrombocytopenia. The binding site of the rifampicin‐dependent antibody, located in the GPIb/IX complex, seems to be a favoured target for antibodies induced by different drugs.