In vitro tests were done on the serum and platelets of two patients who had thrombocytopenia while taking desipramine (Pertofrane®), the active metabolite of imipramine (Tofranil®).

The indirect agglutination test with barium sulfate demonstrated the presence of antibodies against desipramine (titer of 1:256). Follow-up studies showed decreasing antibody titers in both patients after discontinuation of the drug. By complete inhibition of clot retraction and by platelet agglutination, the platelets were shown to be involved in the antigen-antibody reaction.

The antibodies against desipramine were characterized as 7S-IgG types for both patients. The characterization of antibodies may prove to be a useful step in clarifying the mechanisms involved in drug-induced blood dyscrasias.

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