Thrombocytopenia induced by vancomycin-dependent platelet antibody.
OBJECTIVE
Many drugs are associated with thrombocytopenic purpura through immune-mediated platelet destruction. The case of a woman who suffered life-threatening thrombocytopenia during vancomycin treatment for Staphylococcus aureus septicemia is reported.


METHODS
Conventional clinical and laboratory methods, including flow cytometry.


RESULTS
After treatment of septicemia with vancomycin, severe thrombocytopenia and bleeding occurred, without detection of drug-dependent platelet antibodies (DDPA). This was followed by vegetative endocarditis, whereupon antibiotics were withdrawn so as to isolate the organism. The thrombocytopenia was corrected. On day 34, antibiotics including vancomycin were reinstituted, and three days later thrombocytopenia recurred. With a change in antibiotics, the platelet count corrected itself within four days.


CONCLUSIONS
Vancomycin may induce potentially severe immunological thrombocytopenia.
Mizon
P
P
Laboratoire d'Hématologie, Hôpital C.-Huriez, CHRU Lille, France.
Kiefel
V
V
Mannessier
L
L
Mueller-Eckhardt
C
C
Goudemand
J
J
D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001792:Blood Platelets / Q000276:immunology*; D005260:Female; D006801:Humans; D018805:Sepsis / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000276:immunology*; D014640:Vancomycin / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D014640:Vancomycin