A Case of Vancomycin-Induced Immune Thrombocytopenia.
| Autor: | MacDougall KN; Internal Medicine, Staten Island University Hospital, Northwell Health, New York, USA., Parylo S; Hematology/Oncology, Staten Island University Hospital, New York, USA., Sokoloff A; Hematology/Oncology, Staten Island University Hospital, Northwell Health, New York, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2020 May 03; Vol. 12 (5), pp. e7940. Date of Electronic Publication: 2020 May 03. |
| DOI: | 10.7759/cureus.7940 |
| Abstrakt: | Vancomycin-induced immune thrombocytopenia (ITP) is a rare, potentially life-threatening complication from an antibiotic frequently used in medical practice. We report a case of an 81-year-old male with recent removal of an infected right knee prosthesis and insertion of an articulating antibiotic spacer, presenting from rehabilitation for severe thrombocytopenia (1 X 10 3 /µL). The patient's thrombocytopenia was initially falsely attributed to rifampin-induced ITP, a much more common cause of drug-induced thrombocytopenia. Only later, after a second precipitous drop in platelet count, vancomycin was correctly identified as the culprit. The patient's serum was tested for drug-dependent platelet antibodies with and without vancomycin. A positive reaction for IgG was detected by flow cytometry in the absence of vancomycin, which was potentiated in the presence of vancomycin. The result indicated the presence of vancomycin-dependent and nondrug-dependent platelet reactive antibodies and confirmed the diagnosis of vancomycin-induced ITP. In this case, the correct diagnosis was masked by the simultaneous administration of two drugs that cause drug-induced ITP and highlights the importance of early recognition of rare, vancomycin-induced ITP. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2020, MacDougall et al.) |
| Databáze: | MEDLINE |
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