Rosuvastatin-induced thrombocytopenic purpura - A case report

Many medications can cause thrombocytopenic purpura, including some hypolipidemic agents. This is the fi rst case report of thrombocytopenic purpura due to the 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor, rosuvastatin. A 57-year-old Asian man developed multiple petechiae and purpura one month after receiving rosuvastatin in a dosage of 20 mg/day. When the drug was stopped and the patient was treated with systemic methylprednisolone, 24 mg/day, his symptoms cleared within 4 weeks. The symptoms may have been due to an immune-mediated reaction. Also, since statins can alter antiplatelet and antithrombotic properties through significant inhibition of the activated platelet thrombin receptor (Proteinase-Activated Receptor-1), an overwhelming inhibition of platelet thrombin receptors might also have caused the thrombocytopenia. Because rosuvastatin is used throughout the world to treat hyperlipidemia, and Asian patients have a twofold higher systemic exposure than do Caucasian patients, physicians should be familiar with its possible adverse effects, and use with caution when determining the starting dose, especially among Asian patients.