Which is Responsible for Bradycardia in Woman Treated for Incomplete Abortion and Thrombocytopenia? Intravenous Immunoglobulins, Methylprednisolone or Clindamycin

Abstract

Clindamycin, IVIg, and corticosteroids are widely used in medicine. In this study, we represent an unusual case of sinus bradycardia following the administration of these drugs. The patient was a 31-year-old woman who presented a complaint of vaginal bleeding at Shahid Motahhari Hospital, Urmia, Iran. Vaginal examination revealed active bleeding. Laboratory tests reported a positive HCG level. Ultrasonography was performed, and the results showed the presence of retained products of conception. The patient became a candidate for curettage. The initial pulse rate was tachycardia. Laboratory data were reported, platelet count of 16000. Corticosteroids and IVIgs were started. Due to the possibility of infectious abortion, Clindamycin and Gentamicin was started. About 24 hours after curettage and 4 hours after starting clindamycin, the patient felt dizziness. Vital signs were obtained that PR: 38-40. We concluded that clindamycin and IVIg can result in severe bradycardia, even in patients with no previous cardiac history, especially when combined with corticosteroids. As a result, we recommend physicians be more cautious when administrating these medications.