A case of suspected drug-induced thrombocytopenia after extraction of a third molar

Abstract

A case of thrombocytopenia that rapidly developed 6 days after extraction of an impacted third molar is presented. A 28-year-old man with sudden bleeding from the cavity remaining after extraction of a third molar was referred to our department. Initial laboratory data showed a bleeding time of more than 20 min and a platelet count of 2000/μl. There was no history of hemorrhagic disorders. Finally, the patient was admitted to the department ofinternal medicine of our hospital because of thrombocytopenia. Repeated transfusions of concentrated platelets were effective, and the platelet count remained at 76, 000/μl on the 4 th day after admission. The patient was discharged on the following day with no subsequent sign of recurrence. Further laboratory data showed a considerable increase in PAIgG and no abnormal findings in bone marrow. Because the transfusion of concentrated platelets was effective and five kinds of drugs were administered just before the onset of thrombocytopenia, drug-induced thrombocytopenia was suspected. The results of drug lymphocyte stimulation tests suggested that cefaclor was immunologically associated with this case becauseit was only drug that tested positive.