From the Guidelines
Yes, Mycobacterium abscessus can cause thrombocytopenia, as evidenced by the potential for hematological toxicities, including thrombocytopenia, associated with certain antibiotics used to treat the infection, such as linezolid 1.
Mechanisms of Thrombocytopenia
Thrombocytopenia in the context of Mycobacterium abscessus infection can occur due to several mechanisms, including:
- Bone marrow infiltration by the infection
- Immune-mediated platelet destruction
- Direct suppression of platelet production
- Hematological toxicities associated with antibiotics used to treat the infection, such as linezolid, which can cause thrombocytopenia in approximately 50% of M. abscessus isolates 1
Treatment Considerations
Patients with Mycobacterium abscessus infection who develop thrombocytopenia require prompt treatment of the underlying infection with appropriate antimycobacterial therapy. The specific antibiotic regimen depends on the mycobacterial species involved, with combinations typically including drugs like macrolides, fluoroquinolones, and amikacin for non-tuberculous mycobacteria. Treatment duration is usually prolonged, ranging from 6-12 months. Platelet counts typically improve gradually with effective treatment of the underlying mycobacterial infection.
Key Points to Consider
- Mycobacterium abscessus infection can cause thrombocytopenia through various mechanisms
- Antibiotics used to treat the infection, such as linezolid, can cause hematological toxicities, including thrombocytopenia
- Prompt treatment of the underlying infection with appropriate antimycobacterial therapy is essential to improve platelet counts
- Treatment duration is usually prolonged, and platelet counts typically improve gradually with effective treatment 1
From the Research
Mycobacterium abscesses and Thrombocytopenia
There are no research papers to assist in answering this question, as the provided studies focus on thrombocytopenia caused by antitubercular drugs, not Mycobacterium abscesses itself.
Thrombocytopenia caused by Antitubercular Drugs
- Thrombocytopenia can be caused by various antitubercular drugs, including rifampicin 2, 3, 4, 5 and isoniazid 4, 6.
- Pyrazinamide has also been suspected to cause thrombocytopenia in some cases 2, 3.
- The mechanism of thrombocytopenia is often immune-mediated, with drugs inducing the production of platelet-associated IgG 3, 6.
- Discontinuation of the offending drug and administration of prednisolone or platelet transfusions can help resolve thrombocytopenia 3, 4, 6, 5.