title: Protein binding of vancomycin in a patient with immunoglobulin A myeloma.
abstract: Atypical vancomycin pharmacokinetics were observed in an immunoglobulin A myeloma patient. Drug concentrations in serum were extremely elevated, the elimination half-life was prolonged despite normal renal function, and the vancomycin therapy was ineffective. Extensive binding of vancomycin, presumably by high concentrations of an aberrant immunoglobulin A protein, may have accounted for these observations.
authors.affiliation: Department of Pharmacy, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, Maryland 21205.
authors.forename: T G
authors.initials: TG
authors.lastname: Cantú
authors.forename: J D
authors.initials: JD
authors.lastname: Dick
authors.forename: D E
authors.initials: DE
authors.lastname: Elliott
authors.forename: R L
authors.initials: RL
authors.lastname: Humphrey
authors.forename: D M
authors.initials: DM
authors.lastname: Kornhauser
mesh_terms: D001424:Bacterial Infections / Q000188:drug therapy; D001798:Blood Proteins / Q000378:metabolism; D005260:Female; D006207:Half-Life; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000276:immunology / Q000378:metabolism*; D009194:Myeloma Proteins / Q000276:immunology / Q000378:metabolism; D011485:Protein Binding; D014640:Vancomycin / Q000493:pharmacokinetics* / Q000627:therapeutic use
chemical_list: D001798:Blood Proteins; D007070:Immunoglobulin A; D009194:Myeloma Proteins; D014640:Vancomycin