[Acquired coagulopathy caused by administration of parenteral broad-spectrum antibiotics].
Between October 1988 and May 1989, four cancer patients treated by broad-spectrum antibiotics developed a hemorrhagic diathesis induced by vitamin k (VK) deficiency. Activated partial thromboplastin time (APTT), prothrombin time (PT), factor II (FII) and protein induced by vitamin k absence of antagonist-II (PIVKA-II) were measured after administration of antibiotics and VK in all 4 patients. All these patients had been receiving intravenous hyperalimentation (IVH) and antibiotics for various infections. But all or them developed hemorrhagic diathesis within five days after the initiation of broad-spectrum cephem antibiotics (LMOX or CMNX). The abnormalities were 1) marked decrease of F II (6-18%), 2) prolongation of APTT (58.4-200 seconds), 3) prolongation of PT (7-21%), 4) marked increase of PIVKA-II (17-80 less than AU/ml). After being treated by intravenous administration of VK, hemorrhagic diathesis and abnormalities of coagulation tests except for PIVKA-II were corrected quickly in three evaluated patients. The measurement of PIVKA-II seemed to be useful to diagnose the hemorrhagic diathesis caused by VK deficiency in the patients during administration of antibiotics.
Kikuchi
S
S
Division of Hematology-Oncology and Clinical Laboratory, National Cancer Center Hospital, Tokyo.
Ando
A
A
Minato
K
K
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002511:Cephalosporins / Q000008:administration & dosage / Q000009:adverse effects*; D002513:Cephamycins / Q000009:adverse effects; D006474:Hemorrhagic Disorders / Q000139:chemically induced / Q000209:etiology*; D006801:Humans; D008297:Male; D009070:Moxalactam / Q000009:adverse effects; D010289:Parenteral Nutrition, Total; D011498:Protein Precursors / Q000378:metabolism; D011516:Prothrombin / Q000378:metabolism; D014813:Vitamin K Deficiency / Q000097:blood / Q000150:complications*
D015415:Biomarkers; D002511:Cephalosporins; D002513:Cephamycins; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin; C046079:cefminox; D009070:Moxalactam