Back issues No.4 - 2009 / Case Report  

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Rosuvastatin-Induced Thrombocytopenic Purpura-A Case Report
Zheng-Wei Lin, Hsin-Chun Ho, Chih-Hsun Yang, Rosaline Chung-Yee Hui, Wen-Hung Chung
Dermatol Sinica 27: 235-240, 2009

Many medications can cause thrombocytopenic purpura, including some hypolipidemic
agents. This is the fi rst case report of thrombocytopenic purpura due to the 3-hydroxy-3-methylglutaryl-
coenzyme A reductase inhibitor, rosuvastatin. A 57-year-old Asian man developed
multiple petechiae and purpura one month after receiving rosuvastatin in a dosage of 20 mg/day.
When the drug was stopped and the patient was treated with systemic methylprednisolone, 24
mg/day, his symptoms cleared within 4 weeks. The symptoms may have been due to an immunemediated
reaction. Also, since statins can alter antiplatelet and antithrombotic properties through
significant inhibition of the activated platelet thrombin receptor (Proteinase-Activated Receptor-
1), an overwhelming inhibition of platelet thrombin receptors might also have caused the
thrombocytopenia. Because rosuvastatin is used throughout the world to treat hyperlipidemia,
and Asian patients have a twofold higher systemic exposure than do Caucasian patients, physicians
should be familiar with its possible adverse effects, and use with caution when determining
the starting dose, especially among Asian patients.

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