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Severe immune thrombocytopaenia in a patient taking benznidazole for chronic Chagas disease
  1. Clara Crespillo-Andújar1,
  2. María Calbacho Robles2,
  3. Francesca F Norman3,
  4. Jose A Pérez-Molina3
  1. 1National Referral Unit for Tropical and Travel Medicine, Department of Internal Medicine, Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, Spain
  2. 2Department of Hematology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
  3. 3National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
  1. Correspondence to Dr Clara Crespillo-Andújar, clara.crespillo{at}


Chagas disease is a parasitic disease that mostly affects Latin American countries, but it has currently become a worldwide epidemic due to migration. Both drugs marketed for its treatment (benznidazole and nifurtimox) are associated with a high rate of adverse reactions. Benznidazole is preferred initially because of its more favourable toxicity profile and perceived greater efficacy. Hypersensitivity dermatological reactions, gastrointestinal and neurological disturbances represent the most common drug-related adverse events. General symptoms such as fever, arthralgia, myalgia or bone marrow depression (leucopaenia) are seen less frequently. We describe the case of a 33-year-old woman with chronic Chagas disease who presented with acute gingival bleeding and severe thrombocytopaenia, probably related to benznidazole treatment. Temporal association with drug initiation and recovery after treatment withdrawal were demonstrated. Clinicians should be aware of the possible association between immune thrombocytopaenia and benznidazole, even though the pathogenesis remains unclear at present.

  • tropical medicine (infectious disease)
  • drugs and medicines
  • haematology (drugs and medicines)

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  • Contributors JAP-M, FFN and MCR were involved in management of the patient. CC-A wrote the first draft of the manuscript. JAP-M, FFN and MCR reviewed and edited the manuscript. All of the authors have seen and approved the final text.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.