ciprofloxacin induced itp

Greetings!
In early December I was prescribed ciprofloxacin and was achy and bruising on the second day. I discontinued us on the forth day. The aches went away but the bruising became worse. after a week, I called my dr, to document this reaction. I didn't feel it was an emergency as I otherwise felt fine, and I was confident the bruises would go away on their own. When I went in, my platelets were 1 - 3,000! Since then I have received 3 infusions of platelets, winRho, a CT scan and have just finished my 3rd infusion of Rituxan. My dr is aching to take my spleen out. My platelets have reached 85 - 90,000 but always crash 20 or lower. Before my 3rd infusion of Rituxan I was at 40,000+. My dr doesn't seem to think this is a successful number. I think it is!!! should these numbers be going up faster? Should I be worried? She wants my speen out and I am not at all comfortable with that. Also, is it common to have sore lymph nodes on the 2nd day after a rituxan infusion? It goes away after one day.
I found this site yesterday...and cried. I want to thank everyone that makes this site possible. I have been feeling isolated and confused. Thank you so much!

Hi Timons,

I'm glad you found us. I hope that you have the option of getting a second opinion. That's always a good idea before surgery....in addition, it sounds like your treatment so far has been a bit non-standard.

I don't see that you were given steroids, which is typically a first treatment. Also, platelet transfusions are not usually effective for ITP.

And....if the total sum of your symptoms is easy bruising, it might be a bit hasty to be talking splenectomy. There might be something in your situation or history that means that is the best choice, but from what's in your post, I think you're right to hesitate.

Keep reading, you'll learn a lot here. Don't forget that most of what's on here is opinions, and that everyone is different. It's still a very good way to educate yourself on how others have handled ITP (and doctors!).

timons,
is your doctor a hematologist? You need a hematologist. I totally agree with you, you may well be at a safe count over 40k and it is much too soon to take out your spleen. Rituxan takes a while to work and you may not be seeing the full effect of it. Your doctor is throwing too many treatments at you too fast, she sounds unfamiliar with ITP. And since your ITP was apparently drug induced, it might resolve itself (doesn't always, but might).
Erica

There is no way to tell for sure, but I started having a problem with low platelets after I was prescribed nitrofuran for a UTI. (I also have had Sjogren's Syndrome, an autoimmune illness, for twenty years, but never before had a problem with my platelet count. My hemotologist prescribed prednisone, starting at 80 mg and decreasing it gradually. At first after starting the prednisone my platelet count went way up, but after I finished the prednisone, they were way down, so I am now on my second round of prednisone (this week I am at 5 mg. a day). My platelets are gradually going down again, but so are within average range. One of the new things I am doing is really watching what I eat: NO sugar as much as possible (I love chocolates and sweets, but have totally given them up), lots of leafy dark green salads, and 3000 mg of vitamin C every day (I take Emergen-C). I don't know if this has made a difference, but I think it has.
It seems removing your speen is really drastic, and if you can, I would suggest a second opinion. (My hemotologist suggested IVIG next if the prednisone doesn't work. I am still looking at my options.) Good luck with everything.

Hello Timmons! ITP is often drug induced, sometimes it resolves in time and sometimes it does not. I agree with Erica and Tamar. It sounds like you need a second opinion. They are also right about Rituxan. Most people do not see a rise in counts until 4 to 12 weeks after the last infusion. IVIG, Win-Rho and Prednisone are known to work much faster, if a person is responsive. Platelet transfusions are useless and not used as a treatment (only in emergency situations). IVIG is known to be a temporary solution though and most use it for a rescue treatment and not necessarily a remission.

Yes, 40 is a safe number and although it's not a 'normal' count, it can be acceptable to live with (as long as you are not engaging in a risky lifestyle). Way too soon to discuss splenectomy.

I was on Prednisone until the end of January. I am being dexamethisone with the Rituxan. I've seen 3 hematologists. I'm scheduled with whoever is available. All my doctors say they have never seen ITP as a reaction to an antibiotic. I have always been a very healthy until taking the antibiotic for a uti. Consequently, I feel like i'm being ignored. I have an appt. with a surgeon next week just in case my platelets aren't going up. I agree with the hasty. My most recent dr. threatened to put me back on steroids if i didn't see the surgeon. I would like to cancel the appt with the surgeon but am worried. A semi-retired hematologist told me that he had a patient that lived for 15 years with platelets below 15.000. This got my present heme. very upset. Every dr i've seen except the semi-retired one has told me that they are afraid i am going to slip, hit my head and die. I have never slipped and hit my head. Why would that happen now?
Thanks so much for your responses! They are uplifting. I needed this.

timons,
You are so right on all counts. No pun intended as I do not care for puns. Even if you suddenly slipped, at counts in the 40s you might be just fine - although if you did oddly suddenly slip and bang you head you should probably get it checked out. Many on this board have lived for decades with very low counts. And you can't be 'put on steroids' against your will.
I'm sorry to hear your three hematologists are so uninformed and reactive!
Erica

Is there another practice you could go to? I'm not too impressed with what you are telling us. You do not have to do anything you don't want to do.

Thrombocytopenia can occur with an antibiotic (or any other drug).

Hematologic – Eosinophilia (0.6%), leukopenia (0.4%), decreased blood platelets (0.1%), elevated blood platelets (0.1%), pancytopenia (0.1%).

www.rxlist.com/cipro-drug.htm

I was interested in your conclusion that itp was result of an antibiotic for uti. I have had Sjogren's Syndrome for 20 years (I am 68) and my platelet count has always been fine. A year and a half ago I was prescribed nitrofuran for a uti and shortly after that my platelets plummeted. I read the possible side effects of nitrofuran and one was a drop in platelets.
I strongly feel that there is a possible connection between certain antibiotics and itp (which I am now having a terrible time with!)

In any case, best of luck to you!

I am so sorry for your health problems.
I have had Sjogrens Syndrome for 20 years and my platelets have always been good. About a year and a half ago, I took nitrofuran, an antibiotic for UTI. UTI came back again, and I took another round of nitrofuran. Since then, my platelets have dopped. I went on prednisone, and as I decreased dose of prednisone, my platelets, decreased (down to 18,000). Another round of prednisone, which I am still on.

I guess my point in this is: I think the FDA needs to take a closer look at the side effects of many of these antibiotics such as cipro and nitrofuran....are they doing more harm than good.

I do hope your health gets better and hope you have the best of doctors.

All antibiotics list thrombocytopenia as a possible side effect. They can't get rid of them all. There are much more serious things they can cause too. Benefit vs risk.