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Leukopenia and Thrombocytopenia Caused by Thiazolidinediones

Colleen Digman, MD; Andreas K. Klein, MD; and Anastassios G. Pittas, MD
[+] Article, Author, and Disclosure Information

From Tufts-New England Medical Center, Boston, MA 02111.

Potential Financial Conflicts of Interest: Consultancies: A.G. Pittas (Takeda); Honoraria: A.G. Pittas (Takeda).

Ann Intern Med. 2005;143(6):465-466. doi:10.7326/0003-4819-143-6-200509200-00016
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Rosiglitazone causes myelosuppression or myeloprotection?
Posted on April 25, 2006
Veerendra M Chadachan
Tan Tock Seng Hospital, Singapore
Conflict of Interest: None Declared

Sir, I was a bit surprised by reading this interesting case report which mentioned a potentially fatal side effect, myelosuppression, caused by a popular antidiabetic medicine, rosiglitazone. This is in contrast to a previous report from animal studies, which mentioned that rosiglitazone may be myeloprotective. Infact that report suggested that rosiglitazone could offer hope of moderating myelotoxicity induced by chemotherapy agents and thus accelerating recovery.

The patient in the current case had a baseline low normal thrombocytopenia, which possibly made him susceptible to the myelosuppressive effects of rosiglitazone. Whether the activation of PPAR- gamma receptors by the thiazolidinediones acts differently in different groups of patients is interesting to know.


1. Katayoun Djazayeri et al, Accelerated recovery of 5-fluorouracil- damaged bone marrow after rosiglitazone treatment. Eur J Pharmacol. 2005 Oct 17;522:122-9.

2. Ilona Benko et al, Rosiglitazone-induced protection against myelotoxicity produced by 5-fluorouracil. Eur J Pharmacol. 2003 Sep 12;477:179-82

Conflict of Interest:

None declared

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