Acute-Onset Thrombocytopenia Induced by Dihydroxyaluminum Aminoacetate, Heavy Magnesium Carbonate and Aspirin Tablets (II): A Case Report and Literature Review

Abstract Dihydroxyaluminum Aminoacetate, Heavy Magnesium Carbonate and Aspirin Tablets (II) are a compound formulation widely used for cardiovascular and cerebrovascular disease prevention, combining antiplatelet effects with gastric mucosal protection. We report a case of a 71-year-old woman with type 2 diabetes mellitus and a history of ischemic stroke who developed acute-onset thrombocytopenia during hospitalization. Her platelet count dropped precipitously from 202×10⁹/L to 25×10⁹/L without clinical signs of bleeding. Comprehensive workups excluded infection, bone marrow failure, and other secondary causes. A detailed review of her medication timeline identified Dihydroxyaluminum Aminoacetate, Heavy Magnesium Carbonate and Aspirin Tablets (II) as the likely culprit. The drug was discontinued, and platelet counts gradually recovered to baseline. Causality was supported by the Naranjo Adverse Drug Reaction Probability Scale with a score of 8, indicating a probable relationship. To our knowledge, this is the first report linking Dihydroxyaluminum Aminoacetate, Heavy Magnesium Carbonate and Aspirin Tablets (II) to thrombocytopenia. This case highlights the importance of monitoring hematologic parameters even with low-dose aspirin formulations and raises clinical awareness of potential immune-mediated or idiosyncratic drug-induced thrombocytopenia.