Arthritis Drug Diclofenac Can Cause ITP, Anemia

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(Diclofenac is a drug used to alleviate pain and stiffness in

arthritis and gout. It may also be used in other situations.)

Transfusion 2003 Mar;43(3):345-9

Diclofenac-induced antibodies against RBCs and platelets: two case

reports and a concise review.

Meyer O, Hoffmann T, Aslan T, Ahrens N, Kiesewetter H, Salama A.

University Clinic Charite, Institute for Transfusion Medicine,

Humboldt University of Berlin, Germany. oliver.meyer@...

BACKGROUND: Diclofenac has frequently been implicated as the cause of

immune hemolytic anemias and less frequently of immune

thrombocytopenia. The presence of the causative antibodies has only

been demonstrated in patients with immune hemolytic anemia, but not

yet in patients with thrombocytopenia. The cases of two patients in

whom diclofenac simultaneously induced antibodies against platelets

and RBCs are reported.

STUDY DESIGN AND METHODS: The investigation was carried out with

standard serologic tests for detection of antibodies against

platelets and RBCs. The patients' sera were tested in the presence

and absence of diclofenac and its metabolites.

RESULTS: One of the two patients developed severe hemolysis and

significant thrombocytopenic purpura. The other patient developed

significant thrombocytopenia but no hemolysis. Both patients had a

positive DAT and drug- and/or metabolite-dependent antibodies against

RBCs and platelets.

CONCLUSION: Based on our findings and those of other investigators,

we believe that diclofenac leads to the production of antibodies

against RBCs and/or platelets.