While the specific cause behind why ITP develops is usually unknown and can differ from person to person, it is known that numerous medications can cause a short term low platelet count. Although not common, more than 100 drugs as well as some herbal remedies and certain foods have been shown to trigger thrombocytopenia.
Some of the more common types of substance-induced thrombocytopenia include:
Heparin-Induced Thrombocytopenia
Many hospitalized patients receive heparin to prevent clotting. When antibodies form against heparin, they can also bind to a protein on platelets causing them to become very sticky. This process may cause life-threatening clots.
Alcohol-Induced Thrombocytopenia
Drinking alcoholic beverages regularly and in higher than recommended quantity has been shown to cause bone marrow suppression, defective platelet formation, a decrease the lifespan of a platelet leading to premature removal from the body, and impaired platelet function. When repeated over many years, alcohol consumption can damage the liver, the organ responsible for making clotting factors and thrombopoietin, the protein that stimulates platelet production.
Vaccine-Induced Thrombocytopenia
The measles, mumps and rubella (MMR) vaccination has been shown to cause thrombocytopenia in one of 25,000 to 40,000 vaccinations. There are also reports of low platelets resulting from the pneumonia, H influenzae B, varicella zoster virus (VZV), hepatitis B vaccinations, and even the SARS-CoV-2 vaccines.
Drug-Induced Thrombocytopenia
Almost all chemotherapy drugs used to treat cancer will affect the bone marrow, resulting in impaired platelet production. In other cases, the body can develop a cross-reaction to the medication and develop antibodies to both the drug and platelets.
Toxin-Induced Thrombocytopenia
Many chemicals, both naturally occurring as well as those used in everything from industrial production to lawn care, have been shown to trigger autoimmunity of one type or another.
Food-Induced Thrombocytopenia
Some foods, particularly those that contain quinine (such as tonic water, bitter melon) or aspartame (sweeteners used in diet soda) have been shown to trigger low platelets. Also, food sensitivity or allergies may create a heightened immune response that may lead to a reduced platelet count.
Resources for Substance Induced Thrombocytopenia:
- https://www.nhlbi.nih.gov/health/thrombocytopenia
- https://www.ijidonline.com/article/S1201-9712(20)30629-9/pdf
- https://www.itpsupport.org.uk/index.php/en/vaccinations-and-itp
