A Rare Case: Rifampin-Induced Thrombocytopenia

Background/Aims: Immune thrombocytopenia (ITP) is a hematological disorder that may present with oral bleeding, petechiae, ecchymosis, and nasal bleeding. Although tuberculosis remains prevalent in Turkey and rifampin is essential in its treatment, rare cases of rifampin-induced immune thrombocytopenia have been reported. This case aims to highlight the potential link between rifampin use and thrombocytopenia. Methods: A 76-year-old male patient who had been receiving rifampin for tuberculosis was evaluated after presenting with mucocutaneous bleeding. Clinical history, physical examination, and laboratory findings were assessed. Differential diagnoses such as pseudothrombocytopenia, myelodysplastic syndrome, and infection were excluded. Results: The patient was admitted with gum and nasal bleeding, and his platelet count was 3,000/mm³. Following the suspicion of rifampin-induced thrombocytopenia, rifampin was discontinued. Treatment with intravenous immunoglobulin (IVIG) and corticosteroids led to a gradual improvement in platelet count. Conclusions: Although rifampin-induced immune thrombocytopenia is rare, it should be considered in patients who develop thrombocytopenia during anti-tuberculosis therapy. Early recognition and intervention can prevent serious complications.