Criteria for article assessment



1) Ingestion of candidate substance preceded thrombocytopenia, and

2) Platelet count recovered to normal or to the baseline level if the patient had an established disorder with chronic mild thrombocytopenia


1) Candidate substance was only suspected agent ingested prior to onset of thrombocytopenia or

2) Other agents were ingested prior to onset of thrombocytopenia but were reintroduced, or continued, after discontinuation of candidate substance with sustained normal platelet count


Other etiologies for thrombocytopenia were excluded


Re-exposure to the substance resulted in recurrent acute thrombocytopenia


Substance-dependent platelet-reactive antibodies were identified

Levels of evidence


1 [Definite]

Criteria 1, 2, 3, 4 or 1, 2, 3, 5 met

2 [Probable]

Criteria 1, 2, 3 met, but not criteria 4 or 5

3 [Possible]

Criterion 1 met, but not criteria 2 and 3, and not criteria 4 or 5

4 [Unlikely]

Criterion 1 not met or re-exposure does not result in recurrent thrombocytopenia

5 [Excluded]

Criteria for excluding articles from review:

1. Insufficient data to evaluate an association between the

reported substance and thrombocytopenia

2. Platelet count not less than 100,000/l

3. Substance is known to be [a]toxic, [b] illegal, or [c] is

available only for research

4. Substance was taken as an overdose with intention to