title: Hypercoagulopathy with piperacillin administration in osteomyelitis.
abstract: A 51-year-old man with osteomyelitis developed acute renal failure and superior mesenteric venous (SMV) thrombosis after piperacillin (PIPC) treatment. Coagulation profile disclosed disseminated intravascular coagulation (DIC). The serum levels of IgE and eosinophil cationic protein showed significant increases, while a lymphocyte stimulation test with PIPC also demonstrated an extremely high index. These observations suggest that hypersensitivity to PIPC might play a role in the pathogenesis of acute renal failure and SMV thrombosis due to hypercoagulopathy. Withdrawal of PIPC and anticoagulation therapy resulted in clinical improvement and normalization of the affected laboratory data. This is the first report to describe PIPC-induced hypercoagulopathy.
authors.affiliation: Third Department of Internal Medicine, Kansai Medical University, Osaka.
authors.forename: H
authors.initials: H
authors.lastname: Miyazaki
authors.forename: S
authors.initials: S
authors.lastname: Yanagitani
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: K
authors.initials: K
authors.lastname: Yoshida
authors.forename: Y
authors.initials: Y
authors.lastname: Amoh
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Kubota
authors.forename: K
authors.initials: K
authors.lastname: Inoue
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000139:chemically induced*; D004342:Drug Hypersensitivity / Q000209:etiology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy*; D010406:Penicillins / Q000008:administration & dosage / Q000009:adverse effects*; D010878:Piperacillin / Q000008:administration & dosage / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000139:chemically induced
chemical_list: D010406:Penicillins; D010878:Piperacillin