title: Vancomycin-induced Immune Thrombocytopenia Proven by the Detection of Vancomycin-dependent Anti-platelet Antibody with Flow Cytometry.
abstract: Vancomycin-induced thrombocytopenia is a rare adverse reaction that may be overlooked because no specific diagnostic test is currently available. We herein report a patient with vancomycin-induced immune thrombocytopenia who was diagnosed by the detection of vancomycin-dependent anti-platelet antibody with flow cytometry. An IgG antibody in the patient's serum reacted with platelets only in the presence of vancomycin. Severe thrombocytopenia gave rise to life-threatening gastrointestinal bleeding, which was quickly resolved after effective platelet transfusion following the cessation of vancomycin administration. This report suggests that the flow cytometric test is useful for the differential diagnosis of thrombocytopenia and platelet transfusion should be performed after the cessation of vancomycin administration.
authors.affiliation: Departments of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Yamanouchi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hato
authors.forename: Sanshiro
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Kazuto
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yakushijin
authors.forename: Masaki
authors.initials: M
authors.lastname: Yasukawa
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000276:immunology; D001792:Blood Platelets / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D017713:Platelet Transfusion; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy; D014640:Vancomycin / Q000009:adverse effects* / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D007074:Immunoglobulin G; D014640:Vancomycin