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2280286 
Journal Article 
Immune thrombocytopenia due to a drug metabolite 
Eisner, EV; Shahidi, NT 
1972 
1 
New England Journal of Medicine
ISSN: 0028-4793
EISSN: 1533-4406 
IPA/73/069108 
Engl 
REF 18 
376-381 
eng 
IPA COPYRIGHT: ASHP A patient who developed thrombocytopenia while taking Excedrin (aspirin, caffeine, salicylamide, and acetaminophen) was found to have circulating antibody to a metabolic product of N-acetyl-p-aminophenol acetaminophen, but not to the drug itself. The antibody reacted in vitro with an antigen present in the blood of a normal volunteer who had ingested acetaminophen. The antigenic material was purified from the urine of this volunteer and shown to be the sulfate conjugate of the drug. These findings demonstrate that a drug metabolite may be antigenically active in drug-induced thrombocytopenia when the drug itself is immunologically inert, representing a form of drug-induced thrombocytopenia.