WEDNESDAY, Feb. 28 (HealthDay News) -- Patients treated with vancomycin can develop antiplatelet antibodies that can cause thrombocytopenia and severe bleeding, according to study findings published in the March 1 issue of the New England Journal of Medicine.
Richard H. Aster, M.D., of the Medical College of Wisconsin and the BloodCenter of Wisconsin in Milwaukee, and colleagues analyzed patients from around the United States who were suspected of having vancomycin-triggered thrombocytopenia. Thirty-four patients, about 20 percent of the referred sample, had drug-dependent and platelet-reactive IgG and IgM antibodies, while 25 vancomycin-treated patients who did not develop thrombocytopenia did not have these antibodies.
Severe bleeding occurred in 10 of the 29 patients (34 percent) where clinical follow-up information was available, and these patients were found to have a mean platelet count that was 13,600 per cubic millimeter. Platelet levels returned to baseline when vancomycin was discontinued.
"Laboratory detection of drug-dependent antibodies can be invaluable," writes Theodore E. Warkentin, M.D., of McMaster University in Hamilton, Ontario, Canada, in an accompanying editorial. "Detection of drug-dependent (or drug metabolite-dependent) binding of antibodies to platelet glycoproteins has high specificity but only moderate sensitivity, perhaps because relevant drug metabolites may not be present within the test system."
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