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A 41-year-old man with cervical lymph node tuberculosis developed isolated thrombocytopenia 10 days after starting ethambutol, prompting discontinuation when the patient’s Mycobacterium tuberculosis strain showed no resistance to other first-line agents. The lowest platelet count of 72×109/L occurred 48 hours after stopping ethambutol, and recovery followed within 5 days after stopping only ethambutol. Naranjo score (+6) supported probable causality, consistent with the limited published reports.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/ethambutol-associated-thrombocytopenia-a-rare-case-report-of-drug-induced-platelet-decline-in-tuberculosis-treatment/452440/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/ethambutol-associated-thrombocytopenia-a-rare-case-report-of-drug-induced-platelet-decline-in-tuberculosis-treatment/452440.png","ImageObject",300,407,{"name":92,"@type":93},"awa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"When did thrombocytopenia appear after starting ethambutol?","Question",{"text":112,"@type":113},"Isolated thrombocytopenia was noticed 10 days after the start of antituberculous treatment, leading to discontinuation of ethambutol.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What happened to the platelet count after stopping ethambutol?",{"text":117,"@type":113},"The platelet count nadir of 72×109/L occurred 48 hours after ethambutol discontinuation, and the platelet count recovered rapidly within 5 days.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the relationship between ethambutol and the adverse event evaluated?",{"text":121,"@type":113},"The Naranjo causality score was +6, indicating ethambutol was probably responsible for the adverse event.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},452440,1790996444,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","e-ISSN 1941-5923  \n© Am J Case Rep, 2025; 26: e945090 DOI: 10. 12659/AJCR.945090  \nReceived: 2025.05.08  \nAccepted: 2025.08.09  \nAvailable online: 2025.11.17  \nPublished: 2025.12.20  \nAuthors’ Contribution: Study Design A  \nData Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G  \nABCDEF 1,2 BE 1  \nBE 3  \nBDE 4 DEF 5,6 ABDEF 1,2  \nCorresponding Author: Financial support: Conflict of interest:  \nEthambutol-Associated Thrombocytopenia: A Rare Case Report of Drug-Induced Platelet Decline in Tuberculosis Treatment  \nUgo Francoise  Kim Henry Mohamed Sidibe Valérie Lalande Clément Cholle  Paul Le Turnier  \n1 Infectious and Tropical Diseases Unit, Centre Hospitalier de Cayenne, Cayenne, French Guiana  \n2 Clinical Investigation Center CIC 1424 Inserm, Centre Hospitalier de Cayenne, Cayenne, French Guiana  \n3 Nephrology-Hemodialysis Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana  \n4 Tuberculosis and Mycobacteria Laboratory, Institut Pasteur de Guyane, Cayenne, French Guiana  \n5 Bordeaux Regional Pharmacovigilance Center, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France  \n6 Medical Pharmacology Department, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France  \nUgo Françoise, e-mail: ugo.francoise@ch-cayenne.fr None declared  \nNone declared  \nPatient: Male, 41-year-old  \nFinal Diagnosis: Ethambutol associated thrombocytopenia  \nSymptoms: Thrombocytopenia  \nClinical Procedure: —  \nSpecialty: Infectious Diseases • Pharmacology and Pharmacy  \nObjective: Unusual clinical course  \nBackground: Ethambutol is a first-line treatment for tuberculosis and a cornerstone of treatment for atypical mycobacteria. It is considered to have a low incidence of adverse drug reactions, compared with that of other anti-tuberculosis drugs. Apart from causing optic neuropathies, ethambutol is rarely implicated in the adverse effects of tuberculosis treatment.  \nCase Report: We report the case of a 41-year-old man treated for cervical lymph node tuberculosis who developed ethambutol-induced thrombocytopenia. We reviewed the patient’s medical history to reconstruct the chronology of his treatment and to assess the causal relationship between ethambutol and the adverse event. Isolated thrombocytopenia was noticed 10 days after the start of antituberculous treatment, motivating the discontinuation of ethambutol, as the Mycobacterium tuberculosis strain had no resistance to other first-line antituberculosis drugs. The platelet count nadir of 72×109/L was observed 48 hours after ethambutol discontinuation, after 3 weeks of treatment. Discontinuation of ethambutol alone led to a rapid recovery of the platelet count within 5 days. Despite the absence of drug reintroduction, the Naranjo causality score was +6, indicating that ethambutol was probably responsible for the adverse event. We discussed this case in relation to previously reported cases, and our findings were consistent with the only 2 cases documented in the literature.  \nConclusions: Ethambutol can cause thrombocytopenia, which occurs within 2 weeks of its introduction and disappears within days of its discontinuation.  \nKeywords: Drug-Related Side Effects and Adverse Reactions • Ethambutol • Mycobacterium tuberculosis • Thrombocytopenia  \nFull-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/945090](https://www.amjcaserep.com/abstract/index/idArt/945090)  \n993  —  2  10  \nPublisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher  \nThis work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)  \ne945090-1  \nIndexed in: [","cbCaicEhnToQSirn","https://ap.wps.com/l/cbCaicEhnToQSirn","pdf",525894,"English","# Introduction\n# Case Report\n## Clinical presentation\n## Treatment and laboratory findings\n## Causality assessment\n# Conclusions","[{\"question\":\"When did thrombocytopenia appear after starting ethambutol?\",\"answer\":\"Isolated thrombocytopenia was noticed 10 days after the start of antituberculous treatment, leading to discontinuation of ethambutol.\"},{\"question\":\"What happened to the platelet count after stopping ethambutol?\",\"answer\":\"The platelet count nadir of 72×109/L occurred 48 hours after ethambutol discontinuation, and the platelet count recovered rapidly within 5 days.\"},{\"question\":\"How was the relationship between ethambutol and the adverse event evaluated?\",\"answer\":\"The Naranjo causality score was +6, indicating ethambutol was probably responsible for the adverse event.\"}]","Ethambutol-Associated Thrombocytopenia: A Rare Case Report of Drug-Induced Platelet Decline in Tuberculosis Treatment | PDF",1790737109]