Thrombocytopenia and Leukopenia Associated with Itraconazole

The document from July 15, 1996, describes a case where a 54-year-old man developed thrombocytopenia and leukopenia after being treated with itraconazole for a fungal infection following chemotherapy for acute myelogenous leukemia. The patient's platelet count dropped from 98 to 33 cells/nL, and leukocyte count fell from 9.8 to 3.6 cells/nL after 6 weeks on itraconazole (200 mg/d). A bone marrow biopsy showed reduced megakaryocytes but no leukemia. The patient's blood counts recovered after stopping itraconazole and continuing with other medications, indicating that itraconazole was the likely cause of the blood abnormalities. This case was the first to report such side effects from itraconazole, suggesting that clinicians should monitor for these potential side effects, particularly in cancer patients where they could be mistaken for a recurrence of the disease.