A Parkinsonian Patient Who Developed Thrombocytopenia Associated with Long-term Levodopa Treatment
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Accession number;06A0654495
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| Title;A Parkinsonian Patient Who Developed Thrombocytopenia Associated with Long-term Levodopa Treatment |
| Author;
KAI KEN'ICHI
(Showa Univ., Fujigaoka Hospital, JPN)
WAKAYAMA YOSHIHIRO
(Showa Univ., Fujigaoka Hospital, JPN)
MASAKI HISATSUGU
(Showa Univ., Fujigaoka Hospital, JPN)
IIJIMA SHOJI
(Showa Univ., Fujigaoka Hospital, JPN)
JIMI TAKAHIRO
(Showa Univ., Fujigaoka Hospital, JPN)
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Journal Title;Neurological Therapeutics
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Journal Code:X0110A
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ISSN:0916-8443
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VOL.23;NO.4;PAGE.439-443(2006)
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| Figure&Table&Reference;FIG.2, REF.9 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;A 64-year-old man first noticed bradykinesia and small step gait at around 1980 and was diagnosed as having Parkinson's disease in a university hospital. In August 1987, he moved to the area near to our hospital and visited outpatient clinic of our hospital. At that time the diagnosis of Parkinson's disease was confirmed again. Treatment with the combination drug levodopabenserazide (400mg/day plus 100mg/day, respectively) was continued. With the progress of time the amount of the combination drug levodopa benserazid increased up to 600mg/day plus 150mg/day, respectively. On October 30, 2004, he admitted to our hospital because he had fever and oliguria. The route of administraton of levodopa was changed from oral intake to intravenous dripping. The intravenous administration of levodopa 50mg per day was started and the amount was increased rapidly to 400mg per day. Since the effect was not recognized, the administration was stopped soon and levodopa administration through gastric tube was initiated. To test the effect of levodopa intravenous dripping again, levodopa 200mg per day administration intravenously was started again, at the beginning of January 2005 and the amount of levodopa was increased rapidly to 450mg per day. As the result, the thrombocytopenia appeared. The thrombocyte count was 100,000 on January 7, 2005 and it became 50,000 on the next day. The thrombocyte infusion was done however it was not effective. The levodopa was stopped on January 21, 2005 and the administration of cabergoline 4mg per clay was initiated. The thrombocyte count began to increase at the end of January 2005 and recovered to normal level at the mid-February, 2005. After excluding other potential causes of thrombocytopenia such as ITP, DIC or malignant syndrome, and taking into account the close chronologic relationship between the levodopa withdrawal and platelet recovery, we thought that this patient most likely had a levodopa-induced thrombocytopenia. (author abst.) |
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