Thrombocytopenia Drug Immune Validation of New Biological Test Diagnostic
Thrombocytopenia Drug Immune Validation of New Biological Test Diagnostic
The drug immune thrombocytopenia (TIM) are the most common drug cytopenias. They result from
 a peripheral destruction of platelets in the presence of the drug only. They usually involve
 immunoglobulin G (IgG) directed against either the drug molecule bound to a carrier protein
 or, by autoimmunity, against a hidden epitope newly exposed as a result of treatment. The
 most common drugs involved are quinine, some antibiotics, nonsteroidal anti-inflammatory
 drugs or anticonvulsants but the list is not exhaustive.

 in the case of new-onset thrombocytopenia and after eliminating other possible causes, a TIM
 is suspected but the offending drug is difficult to identify in generally poly-medicated
 patients.

 Several drugs may be suspected and the clinician uses biology for rapid assistance to the
 "de-prescription" and reduces unnecessary therapeutic substitutions in an always difficult
 clinical situation.

 The Immunology Laboratory of the University Hospital of Saint-Etienne has developed a
 biological test of thrombocytopenia induction in the presence of the drug and the patient's
 serum that is to say its antibodies and complement fractions with cytometry reading flow.
 This Induction Test in vitro TIM (TITIM) is simple, fast, inexpensive, easy to transfer in
 hospital laboratories. But this test must be validated on well-documented clinical cases.

 The purpose of this pilot project is to validate the technical and assess the clinical
 specificity of the test TITIM for hard imputability drugs validated by a committee of experts
 combining a posteriori of clinical and biological criteria of routine.
Inclusion Criteria:

 -  hospitalized patients with suspicion of thrombocytopenia drug

 -  consent signed

 Exclusion Criteria:

 -  Thrombocytopenia plants such as secondary to the following molecules: antineoplastic
 (except oxaliplatin which gives TIM), immunosuppressants.

 -  Induced thrombocytopenia heparin and IIb / IIIa glycoproteins (abciximab, tirofiban,
 epifibatide).

 -  Presence of anti platelet antibodies allogeneic or autoimmune which are part of the
 MAIPA test.

 -  Patient exposed to at least one suspect molecule does not exist in water-soluble form
 or drug to which the metabolite is suspected

 -  Patients transfused (plasma, platelets) for less than a month

 -  Patients with an other bloodline