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vancomycin induced thrombocytopenia

Jun Yamanouchi, Takaaki Hato, Sanshiro Shiraishi, Kazuto Takeuchi, Yoshihiro Yakushijin, Masaki Yasukawa
Vancomycin-induced thrombocytopenia is a rare adverse reaction that may be overlooked because no specific diagnostic test is currently available. We herein report a patient with vancomycin-induced immune thrombocytopenia who was diagnosed by the detection of vancomycin-dependent anti-platelet antibody with flow cytometry. An IgG antibody in the patient's serum reacted with platelets only in the presence of vancomycin. Severe thrombocytopenia gave rise to life-threatening gastrointestinal bleeding, which was quickly resolved after effective platelet transfusion following the cessation of vancomycin administration...
2016: Internal Medicine
Samuel A Schueler, Nilima S Shet, Nicholas Stienstra, Daniel C Chen
No abstract text is available yet for this article.
June 2016: American Journal of the Medical Sciences
Carolina Ferrairo Danieletto, Gustavo Zanna Ferreira, Gustavo Jacobucci Farah, Roberto Kenji Nakamura Cuman
INTRODUCTION: Thrombocytopenia is the reduction in the number of blood -platelets, which may be caused by -several different conditions such as sepsis, disseminated intravascular -clotting, and large blood losses. Additionally, in rare situations, thrombocytopenia may also be induced by the use of medicaments. One of these drugs is the vancomycin, a glycopeptide presently used against -serious infections involving Gram-positive bacteria such as the methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus...
April 5, 2016: Special Care in Dentistry
Hassan Al-Jafar, Anas Al-Yousef, Somaya Al-Shatti, Khalifa Al-Banwan
Heparin-induced thrombocytopenia (HIT) is a type of drug-induced immune thrombocytopenia (DITP). DITP is a rare and challenging clinical issue, especially when it is associated with thrombosis. A 62-year-old woman was admitted to our institution with end-stage renal failure. She received heparin for hemodialysis. Six days later, she became febrile and was treated with vancomycin and amikacin antibiotics. Two days after starting the vancomycin, she developed severe thrombocytopenia with extensive gangrenous deep vein thrombosis in her right leg, which required a below-the-knee amputation...
May 2015: Case Reports in Nephrology and Dialysis
Somnath Bose, Ellen Wurm, Marc J Popovich, Bernard J Silver
A 62-year-old woman with prosthetic mitral valve was admitted for explant of an infected prosthetic knee. Perioperatively, she was bridged with heparin and started on empiric vancomycin and piperacillin-tazobactam. Platelet counts dropped precipitously within 2 days reaching a nadir of 6000/μL, without any bleeding. Decline persisted despite substituting heparin with bivalirudin. Antiplatelet factor 4 and anti-PLA1 antigen were negative. Schistocytes were absent. Antibiotics were substituted with daptomycin for suspected drug-induced thrombocytopenia...
November 2015: Journal of Clinical Anesthesia
Niyati Lobo, Kandi Ejiofor, Ramesh Thurairaja, Muhammad Shamim Khan
Thrombocytopenia is a rare side effect of vancomycin, an antibiotic that is often used to treat Gram-positive bacterial infections. A 67-year-old man developed bilateral pulmonary emboli and hospital-acquired pneumonia following left ureteric reimplantation. He was anticoagulated with rivaroxaban and started on intravenous vancomycin and gentamicin for treatment of pneumonia. After five doses of vancomycin, his platelet count dropped to a nadir of 0 × 10(9)/L (baseline: 314 × 10(9)/L) manifesting as visible heavy haematuria and haemodynamic instability due to excessive blood loss...
2015: BMJ Case Reports
Brian R Curtis
Drug-induced immune thrombocytopenia (DIIT) is a relatively uncommon adverse reaction caused by drug-dependent antibodies (DDAbs) that react with platelet membrane glycoproteins only when the implicated drug is present. Although more than 100 drugs have been associated with causing DIIT, recent reviews of available data show that carbamazepine, eptifibatide, ibuprofen, quinidine, quinine, oxaliplatin, rifampin, sulfamethoxazole, trimethoprim, and vancomycin are probably the most frequently implicated. Patients with DIIT typically present with petechiae, bruising, and epistaxis caused by an acute, severe drop in platelet count (often to <20,000 platelets/pL)...
2014: Immunohematology
Mariana Floria, Alain Dive, Michel Buche, Baudouin Marchandise, Erwin Schroder
No abstract text is available yet for this article.
August 2014: Acta Cardiologica
Jonathan F Mailman, Caroline Stigant, Dan Martinusen
OBJECTIVE: To alert clinicians to a serious complication from a commonly prescribed medication, moxifloxacin. CASE SUMMARY: A 65-year-old male, septic, hemodialysis patient developed thrombocytopenia following exposure to vancomycin, ceftazidime, and moxifloxacin. Drug-specific immunoglobulin testing showed positive autoantibodies against only moxifloxacin, and the probability stratification proposed by Naranjo et al would give this case a score of 7-a probable association between moxifloxacin and the adverse event...
March 31, 2014: Annals of Pharmacotherapy
R M Thushara, M Hemshekhar, K Kemparaju, K S Rangappa, S Devaraja, K S Girish
The surfacing of the applied fields of biology such as, biotechnology, pharmacology and drug discovery was a boon to the modern man. However, it had its share of disadvantages too. The indiscriminate use of antibiotics and other biological drugs resulted in numerous adverse reactions including thrombocytopenia. One of the reasons for drug-induced thrombocytopenia could be attributed to an enhanced rate of platelet apoptosis, which is a less investigated aspect. The present essay sheds light on the adverse (pro-apoptotic) effects of some of the commonly used drugs and antibiotics on platelets viz...
February 2014: Archives of Toxicology
Simon P Rowland, Iain Rankin, Hemant Sheth
Vancomycin-induced thrombocytopenia is a rare side effect of a commonly used drug that may cause life-threatening disease. A 51-year-old man was treated for an episode of acute severe alcohol-induced pancreatitis complicated by development of a peripancreatic fluid collection. He developed fever of unknown origin and was treated with intravenous vancomycin and piperacillin with tazobactam. On day 6 of vancomycin therapy his platelet count dropped to 46×10(9)/L (237×10(9)/L on day 1 of treatment) and by day 8 of therapy platelets had fallen to a nadir of 9×10(9)/L...
2013: BMJ Case Reports
Donald M Arnold, Ishac Nazi, Theodore E Warkentin, James W Smith, Lisa J Toltl, James N George, John G Kelton
Drug-induced immune thrombocytopenia (DITP) is a challenging clinical problem that is under-recognized, difficult to diagnose and associated with severe bleeding complications. DITP may be caused by classic drug-dependent platelet antibodies (eg, quinine); haptens (eg, penicillin); fiban-dependent antibodies (eg, tirofiban); monoclonal antibodies (eg, abciximab); autoantibody formation (eg, gold); and immune complex formation (eg, heparin). A thorough clinical history is essential in establishing the diagnosis of DITP and should include exposures to prescription medications, herbal preparations and even certain foods and beverages...
July 2013: Transfusion Medicine Reviews
Syeda T Towhid, Eva-Maria Schmidt, Alexander Tolios, Patrick Münzer, Evi Schmid, Oliver Borst, Meinrad Gawaz, Evi Stegmann, Florian Lang
BACKGROUND/AIMS: Side effects of vancomycin, a widely used antibiotic, include thrombocytopenia. The vancomycin-induced thrombocytopenia has been attributed to immune reactions. At least in theory, thrombocytopenia could result in part from the triggering of apoptosis, which results in cell shrinkage and cell membrane scrambling with subsequent phosphatidylserine exposure at the cell surface. The cell membrane scrambling could be initiated by a signaling involving increase of cytosolic Ca(2+) activity, ceramide formation, mitochondrial depolarization and/or caspase activation...
2013: Cellular Physiology and Biochemistry
D M Arnold, S Kukaswadia, I Nazi, A Esmail, L Dewar, J W Smith, T E Warkentin, J G Kelton
BACKGROUND: Drug-induced immune thrombocytopenia (DITP) can be confirmed by the demonstration of drug-dependent platelet antibodies in vitro; however, laboratory testing is not readily accessible and test methods are not standardized. OBJECTIVE: To identify drugs with the strongest evidence for causing DITP based on clinical and laboratory criteria. PATIENTS/METHODS: We developed a grading system to evaluate the quality of DITP laboratory testing...
January 2013: Journal of Thrombosis and Haemostasis: JTH
Michael A Ruggero, Osama Abdelghany, Jeffrey E Topal
Vancomycin is a glycopeptide antibiotic used in the treatment of gram-positive infections including methicillin-resistant Staphylococcus aureus (MRSA). The most common adverse reaction to vancomycin is red man syndrome, which is a histaminergic reaction causing a rash on the upper torso, neck, and face after rapid infusion of the drug. Less commonly, vancomycin has been associated with thrombocytopenia. The etiology is believed to be the induction of drug-dependent antibodies, which in turn cause immune-mediated destruction of platelets...
November 2012: Pharmacotherapy
Mara N Poulakos, Yasmin Grace, Christina Coakley
PURPOSE: A probable case of linezolid-induced thrombocytopenia is reported. SUMMARY: A 74-year-old Caucasian male with renal dysfunction was diagnosed with diverticulosis. Patient was prescribed linezolid 600 mg orally twice daily for vancomycin-resistant enterococci abdominal infection that developed secondary to colon resection. Upon initiation of linezolid, platelet count dropped from 248 000 cells/mm(3) on day 1 to 97 000 cells/mm(3) on day 5 of treatment. Linezolid was discontinued and platelet counts improved to pretreatment levels...
December 2012: Journal of Pharmacy Practice
Lisa M Harinstein, Sandra L Kane-Gill, Pamela L Smithburger, Colleen M Culley, Vivek K Reddy, Amy L Seybert
PURPOSE: The aim of this study was to assess the performance of a commercially available clinical decision support system (CDSS) drug-laboratory result alert in detecting drug-induced thrombocytopenia in critically ill patients. MATERIALS AND METHODS: Adult patients admitted to the medical and cardiac intensive care unit during an 8-week period and identified by 1 of 3 signals in the CDSS, TheraDoc, were eligible. Alerts were generated when the patient had a low platelet count and was ordered a potentially causal drug...
June 2012: Journal of Critical Care
F Waki, H Ohnishi, T Shintani, M Uemura, K Matsumoto, T Fukumoto, A Kitanaka, Y Kubota, T Tanaka, T Ishida, T Matsunaga
Linezolid (LZD) is the first oxazolidinone antibiotic that is effective against drug-resistant gram-positive organisms. Hematological toxicities such as thrombocytopenia, anemia, and leukocytopenia are common in LZD therapy. However, LZD-induced pure red cell aplasia (PRCA) is very rare. A 56-year-old man with myelodysplastic syndrome underwent allogeneic bone marrow transplantation from a human leukocyte antigen-matched and ABO blood type-matched unrelated male donor. He had bacteremia caused by Staphylococcus epidermidis after engraftment of neutrophils and red blood cells...
August 2012: Transplant Infectious Disease: An Official Journal of the Transplantation Society
S-H Hsiao, C-H Chou, W-L Lin, E-J Lee, L-H Liao, H-J Chang, P-Y Yeh, C-Y Lin, T-J Wu
WHAT IS KNOWN AND OBJECTIVE: Teicoplanin and vancomycin show similar clinical and bacteriological efficacy in clinical trials. Teicoplanin has been reported to have a lower adverse drug reaction (ADR) rate than vancomycin. Cross-reactivity between these two glycopeptides is controversial. Our aim was to study the cross-reactivity between teicoplanin and vancomycin through an assessment of all the reported ADRs of these drugs in our University hospital. METHODS: Over a period of 2 years, 170 cases of vancomycin therapy, which were closely monitored by doctors and clinical pharmacists, were used to analyse ADRs...
June 2012: Journal of Clinical Pharmacy and Therapeutics
Amritpal Anand, Hiteshi K C Chauhan
In hospitalized patients with complex medical problems on numerous drugs, thrombocytopenia may have a multiple confounding etiology. Keeping this in mind, it is of utmost importance to monitor the platelet count regularly during hospitalization and on subsequent follow-up visits, even after the most probable etiology has been identified/most likely causative drug has been withdrawn. Isolated thrombocytopenia with no evidence of microangiopathic hemolysis on the peripheral blood smear in an acutely ill hospitalized patient implicated sepsis, disseminated intravascular coagulation and drugs as the most probable causes...
2011: Platelets
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