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Drug induced thrombocytopenia

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https://www.readbyqxmd.com/read/28331864/cytopenia-occurrence-in-kidney-transplant-recipients-within-early-post-transplant-period
#1
Atefeh Jafari, Parisa Najivash, Mohammad-Reza Khatami, Simin Dashti-Khavidaki
OBJECTIVE: This study assessed incidence, severity, and time to occurrence of drug-induced leukopenia/thrombocytopenia within 1(st) month after kidney transplantation. METHODS: This cross-sectional study was conducted on newly kidney transplant recipients from two hospitals, Iran. Patients with thrombocytopenia due to acute antibody-mediated rejection were excluded from the study. Demographic, clinical, and laboratory data of patients within the 1(st) month after transplantation were collected...
January 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28320219/monitoring-of-argatroban-and-lepirudin
#2
Holger Seidel, Hans-Jürgen Kolde
Monitoring of direct thrombin inhibitors (DTIs) in patients with heparin-induced thrombocytopenia (HIT) is primarily performed using the activated partial thromboplastin time (aPTT). This assay is poorly standardized, reagent dependent, and not DTI specific. We compared aPTT, thrombin time (TT), and prothrombin time (PT) to drug levels obtained by the ecarin chromogenic assay (ECA). We analyzed 495 samples of patients with confirmed or suspected HIT on treatment with either argatroban (n = 37) or lepirudin (n = 80)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28297572/safety-and-efficacy-of-megakaryocytes-induced-from-hematopoietic-stem-cells-in-murine-and-nonhuman-primate-models
#3
Xin Guan, Meng Qin, Yu Zhang, Yanan Wang, Bin Shen, Zhihua Ren, Xinxin Ding, Wei Dai, Yongping Jiang
Because of a lack of platelet supply and a U.S. Food and Drug Administration-approved platelet growth factor, megakaryocytes have emerged as an effective substitute for alleviating thrombocytopenia. Here, we report the development of an efficient two-stage culture system that is free of stroma, animal components, and genetic manipulations for the production of functional megakaryocytes from hematopoietic stem cells. Safety and functional studies were performed in murine and nonhuman primate models. One human cryopreserved cord blood CD34(+) cell could be induced ex vivo to produce up to 1...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28265388/case-report-apixaban-induced-thrombocytopenia
#4
Oliver Snellgrove
Apixaban is a relatively new drug, and its safety profile is still being established. Thrombocytopenia is an uncommon, but life-threatening side effect with no previous published case repots. Clinicians must be aware of this and exercise caution particularly as some studies hint that it may be used in the management of HIT.
March 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28264696/a-rare-case-report-of-acyclovir-induced-immune-thrombocytopenia-with-tongue-hematomas-as-the-first-sign-and-a-literature-review
#5
Xiaowei Hong, Xiaoqian Wang, Zhiyong Wang
BACKGROUND: Acyclovir has been widely used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus (VZV). The common adverse effects of this drug include nausea, diarrhea, headache, dizziness and mental changes. The immune thrombocytopenia induced by acyclovir is rare. CASE PRESENTATION: A 67-year-old Chinese male who was given acyclovir 5 mg kg(-1) 8 hourly intravenously for treatment of VZV infection developed severe thrombocytopenia with fist sign in oral cavity within 10 days of starting using acyclovir...
March 7, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28242109/haemolytic-uraemic-syndrome
#6
REVIEW
Fadi Fakhouri, Julien Zuber, Véronique Frémeaux-Bacchi, Chantal Loirat
Haemolytic uraemic syndrome is a form of thrombotic microangiopathy affecting predominantly the kidney and characterised by a triad of thrombocytopenia, mechanical haemolytic anaemia, and acute kidney injury. The term encompasses several disorders: shiga toxin-induced and pneumococcus-induced haemolytic uraemic syndrome, haemolytic uraemic syndrome associated with complement dysregulation or mutation of diacylglycerol kinase ɛ, haemolytic uraemic syndrome related to cobalamin C defect, and haemolytic uraemic syndrome secondary to a heterogeneous group of causes (infections, drugs, cancer, and systemic diseases)...
February 23, 2017: Lancet
https://www.readbyqxmd.com/read/28222071/combination-of-the-histone-deacetylase-inhibitor-vorinostat-with-bevacizumab-in-patients-with-clear-cell-renal-cell-carcinoma-a-multicentre-single-arm-phase-i-ii-clinical-trial
#7
Roberto Pili, Glenn Liu, Sreenivasulu Chintala, Hendrick Verheul, Shabnam Rehman, Kristopher Attwood, Martin A Lodge, Richard Wahl, James I Martin, Kiersten Marie Miles, Silvia Paesante, Remi Adelaiye, Alejandro Godoy, Serina King, James Zwiebel, Michael A Carducci
BACKGROUND: Class II histone deacetylase (HDAC) inhibitors induce hypoxia-inducible factor-1 and -2α degradation and have antitumour effects in combination with vascular endothelial growth factor (VEGF) inhibitors. In this study, we tested the safety and efficacy of the HDAC inhibitor vorinostat and the VEGF blocker bevacizumab in metastatic clear-cell renal cell carcinoma (ccRCC) patients previously treated with different drugs including sunitinib, sorafenib, axitinib, interleukin-2, interferon, and temsirolimus...
February 21, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28217621/refractory-anemia-in-human-immunodeficiency-virus-expect-the-unexpected
#8
Sumeet Prakash Mirgh, Vikas A Mishra, Virti D Shah, Jehangir Soli Sorabjee
Pure red cell aplasia (PRCA) is an uncommon hematological disorder affecting selectively the erythroid cell lines. PRCA is defined as anemia with normal leukocyte and platelet counts, a corrected reticulocyte count <1%, <5% erythroid precursors in the bone marrow and an absence of hemolysis. We describe a case of Zidovudine (AZT) induced PRCA causing severe anemia in a patient taking antiretroviral therapy (ART) after 4 months of starting therapy and in whom all other causes were excluded. The hematological abnormalities resolved after AZT was replaced with tenofovir and the patient remained transfusion independent thereafter...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28144463/drug-reaction-with-eosinophilia-and-systemic-symptoms-induced-by-valproic-acid-a-case-report
#9
Mahboubeh Darban, Bahador Bagheri
INTRODUCTION: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but life-threatening reaction to drugs such as carbamazepine and allopurinol. The condition is characterized by skin rashes, fever, hematological disturbances, lymphadenopathy, and organ failure, most probably hepatic dysfunction. To date, only a few cases of valproate-induced DRESS syndrome have been reported. CASE PRESENTATION: We report on the case of a 60-year-old man who had been treated with valproic acid some time before being referred to Kowsar Hospital, Semnan, Iran in December 2015...
September 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28143610/severe-toxicity-induced-by-accumulation-of-active-sunitinib-metabolite-in-a-japanese-patient-with-renal-cell-carcinoma-a-case-report
#10
Shinya Takasaki, Masafumi Kikuchi, Yoshihide Kawasaki, Akihiro Ito, Yoichi Arai, Hiroaki Yamaguchi, Nariyasu Mano
BACKGROUND: Sunitinib is a multi-targeted tyrosine kinase inhibitor that is approved for treatment of renal cell carcinoma as an oral anticancer drug. Therapeutic drug monitoring of total sunitinib (sunitinib and N-desethyl sunitinib) is used in our hospital to improve therapeutic efficacy, while preventing adverse effects. Here, we report the first case of a patient with metastatic renal cell carcinoma undergoing hemodialysis and presenting severe adverse events induced by the accumulation of N-desethyl sunitinib...
February 1, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28097007/safety-assessment-in-rats-and-dogs-of-acoustic-cluster-therapy-a-novel-concept-for-ultrasound-mediated-targeted-drug-delivery
#11
Oddvar Myhre, Marie Bjørgan, Derek Grant, Svein-Olaf Hustvedt, Per C Sontum, Hubert Dirven
Acoustic Cluster Therapy (ACT) represents a novel concept for targeted drug delivery. Ultrasound is applied to activate intravenously administered free-flowing clusters of microbubbles and microdroplets within the target pathology, depositing 20-30 μm large bubbles in the microvasculature for 5-10 min. Further application of ultrasound induces biomechanical effects which increase vascular permeability and enhance localized extravasation of coadministered drugs. Herein we report investigations done to assess the preclinical safety of ACT, using doses up to 1 mL/kg (3 μL perfluoromethyl-cyclopentane/kg)...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28052306/laboratory-monitoring-of-parenteral-direct-thrombin-inhibitors
#12
Elizabeth M Van Cott, A Joshua Roberts, William E Dager
Argatroban and bivalirudin are parenteral direct inhibitors of the activity of thrombin, but, unlike heparin, can inhibit both soluble as well as clot-bound thrombin. These agents do not require antithrombin as a cofactor for activity. The parenteral direct thrombin inhibitors (DTIs) can be used in a variety of settings, including heparin-induced thrombocytopenia (HIT) or an allergy to heparin, and patients requiring anticoagulation for an invasive cardiovascular intervention. Both agents have a relatively short half-life in patients without organ system failure and are typically administered by continuous infusion...
January 4, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27986986/a-pharmacokinetic-study-of-lipegfilgrastim-in-children-with-ewing-family-of-tumors-or-rhabdomyosarcoma
#13
Margarita B Belogurova, Zoryana P Kizyma, Miklós Garami, Mónika Csóka, Michael J Lamson, Anton Buchner, Peter Bias, Andreas Lammerich
PURPOSE: Neutropenia is a common complication from chemotherapy, limiting optimal dosing and treatment. Lipegfilgrastim is a long-acting granulocyte colony-stimulating factor developed for the management of chemotherapy-induced neutropenia. The objectives of this phase 1, multinational, open-label, single-arm study were to characterize the pharmacokinetics (PK) and pharmacodynamics (PD) of a single body weight-adjusted dose of lipegfilgrastim and to evaluate the efficacy, safety, and tolerability of the drug in children with Ewing family of tumors or rhabdomyosarcoma treated with myelosuppressive chemotherapy...
January 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/27956417/effects-of-oritavancin-on-coagulation-tests-in-the-clinical-laboratory
#14
Adam Belley, Richard Robson, John L Francis, Dorothy M Adcock, Stefan Tiefenbacher, Christopher M Rubino, Greg Moeck, David Sylvester, Michael N Dudley, Jeffery Loutit
Previous studies have shown that some lipoglycopeptide and lipopeptide antimicrobial agents may cause falsely elevated values for some phospholipid-dependent coagulation tests. The effect of oritavancin, a lipoglycopeptide antibiotic, on coagulation test results was explored using pooled human plasma samples spiked with drug and in a clinical study after an infusion of a single 1,200-mg intravenous dose of oritavancin in normal healthy volunteers. Pooled plasma with oritavancin added ex vivo showed concentration-dependent prolongation of prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (aPTT), and dilute Russell viper venom time (DRVVT) test results...
February 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27927231/identification-of-a-potent-small-molecule-capable-of-regulating-polyploidization-megakaryocyte-maturation-and-platelet-production
#15
Nick Huang, Mabel Lou, Hua Liu, Cecilia Avila, Yupo Ma
BACKGROUND: Megakaryocytic cell maturation involves polyploidization, and megakaryocyte (MK) ploidy correlates with their maturation and platelet production. Retardation of MK maturation is closely associated with poor MK engraftment after cord blood transplantation and neonatal thrombocytopenia. Despite the high prevalence of thrombocytopenia in a range of setting that affect infants to adults, there are still very limited modalities of treatment. METHODS: Human CD34(+) cells were isolated from cord blood or bone marrow samples acquired from consenting patients...
December 8, 2016: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/27903082/itraconazole-induced-thrombocytopenia
#16
Berna Aksoy
Itraconazole is one of the systemic treatment options for extensive tinea versicolor. A male patient who developed thrombocytopenia during the treatment of tinea versicolor by itraconazole is reported in this manuscript. He was diagnosed to develop thrombocytopenia on the third day of treatment. In the literature, there are two reports of itraconazole-induced thrombocytopenia both in malignancy patients. One report contained three patients who developed thrombocytopenia as a result of a drug interaction between bortezomib and itraconazole...
December 21, 2016: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/27879189/gemcitabine-induced-hemolytic-uremic-syndrome-treated-with-eculizumab-or-plasmapheresis-two-case-reports%C3%A2
#17
María Esperanza López Rubio, Raquel Rodado Martínez, María Luisa Illescas, Encarnación Mateo Bosch, Mercedes Martinez Díaz, Lourdes de la Vara Inesta, Basilio Cabezuelo, María Elisa Morales Albuja, Eladio Lucas Guillén, Luisa Jimeno García
BACKGROUND: Drug-induced hemolytic-uremic syndrome (HUS) has shown good response to eculizumab (ECU). We present 2 cases of patients with gemcitabine-induced HUS (GEM-HUS), one of whom was treated with ECU and the other with conventional treatment. Patient 1: A 74-year-old male with resected adenocarcinoma of the pancreas started adjuvant treatment with GEM, but after 5 months GEM was discontinued due to acute kidney injury and severe hypertension. Laboratory analyses identified microangiopathic hemolytic anemia (MHA) and thrombocytopenia...
February 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/27864296/a-mechanistic-investigation-of-thrombotic-microangiopathy-associated-with-iv-abuse-of-opana-er
#18
Ryan Hunt, Ayla Yalamanoglu, James Tumlin, Tal Schiller, Jin Hyen Baek, Andrew Wu, Agnes B Fogo, Haichun Yang, Edward Wong, Peter Miller, Paul W Buehler, Chava Kimchi-Sarfaty
Since 2012, a number of case reports have described the occurrence of thrombotic microangiopathy (TMA) following IV abuse of extended-release oxymorphone hydrochloride (Opana ER), an oral opioid for long-term treatment of chronic pain. Here, we present unique clinical features of 3 patients and investigate IV exposure to the tablet's inert ingredients as a possible causal mechanism. Guinea pigs were used as an animal model to understand the hematopathologic and nephrotoxic potential of the inert ingredient mixture (termed here as PEO+) which primarily contains high-molecular-weight polyethylene oxide (HMW PEO)...
February 16, 2017: Blood
https://www.readbyqxmd.com/read/27849621/vancomycin-induced-thrombocytopenia-in-a-newborn
#19
Kunal Kalra, Hema Gupta Mittal, Arti Maria
Neonatal thrombocytopenia is common and is frequently seen in neonatal sepsis. Drug-induced thrombocytopenia is likely to be missed unless a high index of suspicion is present. Changing of antibiotics for assumed nonresolution of sepsis may lead to persistent thrombocytopenia in a neonate if drug-induced thrombocytopenia is missed. Vancomycin-induced neonatal thrombocytopenia is rarely described in scientific literature. We describe a newborn who was diagnosed with early onset sepsis and vancomycin-induced thrombocytopenia...
December 1, 2016: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/27848915/heparin-monitoring-clinical-outcome-and-practical-approach
#20
REVIEW
Noémie Despas, Anne-Sophie Larock, Hugues Jacqmin, Jonathan Douxfils, Bernard Chatelain, Marc Chatelain, François Mullier
Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate...
December 1, 2016: Annales de Biologie Clinique
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