Vancomycin-induced Immune Thrombocytopenia Proven by the Detection of Vancomycin-dependent Anti-platelet Antibody with Flow Cytometry

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 antibo...

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Bibliographic Details
Published in:Internal Medicine 2016/10/15, Vol.55(20), pp.3035-3038
Main Authors: Yamanouchi, Jun, Hato, Takaaki, Shiraishi, Sanshiro, Takeuchi, Kazuto, Yakushijin, Yoshihiro, Yasukawa, Masaki
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - immunology
anti-platelet antibody
Blood Platelets - immunology
Case Report
Female
Flow Cytometry
Humans
Immunoglobulin G - blood
Platelet Transfusion
Purpura, Thrombocytopenic, Idiopathic - chemically induced
Purpura, Thrombocytopenic, Idiopathic - diagnosis
Purpura, Thrombocytopenic, Idiopathic - therapy
thrombocytopenia
vancomycin
Vancomycin - adverse effects
Vancomycin - immunology
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Summary: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. This report suggests that the flow cytometric test is useful for the differential diagnosis of thrombocytopenia and platelet transfusion should be performed after the cessation of vancomycin administration.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.6902