Suspected doxycycline-induced thrombocytopenia: Two case reports and a review of the literature
Abstract
Rationale: Doxycycline is a broad-spectrum antibiotic widely used in clinical practice. The most common adverse reactions are gastrointestinal disturbances, whereas thrombocytopenia caused by doxycycline is rarely reported.
Patient concerns: Two patients developed severe thrombocytopenia shortly after initiating doxycycline therapy, with platelet counts decreasing post-administration precipitously.
Diagnoses: Drug-induced thrombocytopenia was diagnosed based on the close temporal relationship between doxycycline exposure and cytopenia, together with the exclusion of other common etiologies through clinical and laboratory assessment. Platelet recovery commenced only after doxycycline withdrawal.
Interventions: Treatment included immediate discontinuation of doxycycline, corticosteroid therapy, intravenous immunoglobulin, and platelet transfusion. Specific immunomodulatory and thrombopoietic agents, such as avatrombopag and interleukin-11, were also administered.
Outcomes: Both patients exhibited normalized platelet counts following treatment, without major hemorrhagic events, and achieved complete clinical resolution.
Lessons: These cases suggest that clinicians should be aware of this rare but serious adverse effect. Monitoring platelet counts during doxycycline therapy, particularly in complex patients - especially those receiving multiple medications or with underlying coagulopathy, may help with early detection and timely intervention.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Structural and topological analysis of thiosemicarbazone-based metal complexes: computational and experimental study of bacterial biofilm inhibition and antioxidant activity
- Toward better cures for Mycobacterium abscessus lung disease
- Challenges for global antibiotic regimen planning and establishing antimicrobial resistance targets: implications for the WHO Essential Medicines List and AWaRe antibiotic book dosing
- Design, Synthesis and In vitro Antitubercular Effect of New Chalcone Derivatives Coupled with 1,2,3‐Triazoles: A Computational Docking Techniques
- Upregulation of pmrA, pmrB, pmrC, phoQ, phoP, and arnT genes contributing to resistance to colistin in superbug Klebsiella pneumoniae isolates from human clinical samples in Tehran, Iran
- Whole-genome sequencing of clinical isolates of Citrobacter Europaeus in China carrying blaOXA−48 and blaNDM−1
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.