A Case of Vancomycin-Induced Thrombocytopenia

Jae Hyeon Lee; Dal Sik Kim; Hye Soo Lee; Sam Im Choi; Yong Gon Cho

doi:10.5045/kjh.2009.44.4.294

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Lee, Kim, Lee, Choi, and Cho: A Case of Vancomycin-Induced Thrombocytopenia

Case Report

Korean J Hematol 2009;44(4):294-297.

Published online: 20 December 2009

DOI: https://doi.org/10.5045/kjh.2009.44.4.294

A Case of Vancomycin-Induced Thrombocytopenia

Jae Hyeon Lee, M.D.¹, Dal Sik Kim, M.D., Ph.D.^1,², Hye Soo Lee, M.D., Ph.D.^1,², Sam Im Choi, M.D., Ph.D.^1,², Yong Gon Cho, M.D., Ph.D.^1,^2,

¹Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea

²Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea

Correspondence to：Yong Gon Cho, M.D. Department of Laboratory Medicine, Chonbuk National University Medical School 634-18, Geumam-dong, Deokjin-gu, Jeonju 561-712, Korea Tel: +82-63-250-2388, Fax: +82-63-250-1200 E-mail: choyg@jbnu.ac.kr

Received 26 October 2009 Revised 30 November 2009 Accepted 30 November 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Immune thrombocytopenia is a rare complication associated with vancomycin. A 76-year-old male patient who was treated with vancomycin experienced severe thrombocytopenia and refractoriness as a result of platelet transfusion. Vancomycin-dependent antibodies in his thrombocytopenic serum were detected by flow cytometric analysis. The mechanism of thrombocytopenia is probably related to immunological destruction, as strongly suggested by its association with a specific drug-dependent anti-platelet antibody.

Keywords: Thrombocytopenia, Vancomycin, Drug-induced

References

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Fig. 1.

The course of platelet count, transfusion, and the use of drugs. Thrombocytopenia was detected on day 11, and the use of vancomycin was discontinued on day 12. Abbreviations: HD, hospital day; IPF, immature platelet fraction; PC, platelet concentrates.

Fig. 2.

The results of platelet immunofluorescence test using flow cytometry. The mixture of the patient's sera and serially-diluted vancomycin using drug-free saline in lower histograms generated a fluorescence intensity greater than the control sera in upper histograms. (A) Saline/sera mixture, (B) 1：100 diluted vancomy-cin/sera mixture.

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