The study led by Annette Von Drygalski, M.D., third year internal medicine resident, and Richard H. Aster M.D., professor of medicine at the Medical College, and senior investigator at the Blood Research Institute, will appear in the March 1, 2007, edition of New England Journal of Medicine.
Patients suspected of having thrombocytopenia, or low blood platelet count often associated with bleeding, can be tested for a special type of antibody to see if it is related to medications. For this study, the researchers obtained clinical information on 29 patients who tested positive for vancomycin-dependent platelet antibodies. The patients were seen at major U.S. hospitals.
"We found a close correlation between exposure to vancomycin, development of a vancomycin-dependent antibody, and the onset of severe thrombocytopenia accompanied by serious bleeding in most cases," Says Dr. Aster. "Three of the 29 cases described ended fatally. Serious bleeding appears to have contributed to these outcomes."
It is not widely recognized that vancomycin can cause thrombocytopenia. For that reason, the medication was continued in 15 of the 29 patients while other possible causes for the low platelet count were investigated, according to Dr. Aster. None of these patients had a rise in the platelet count until the vancomycin was discontinued and an alternative antibiotic started. The vancomycin was stopped early in the remaining 14 patients because it was suspected to be the cause of the thrombocytopenia. The platelet count of these patients rose to normal shortly thereafter.
In a separate study, the researchers found that 25 patients given vancomycin who did not develop thrombocytopenia did not develop antibodies.
"Vancomycin has been in widespread use for more than 25 years and can be a life-saving medication when used in the appropriate context," says Dr. Aster. Since only a small fraction of patients given vancomycin produce antibodies that cause thrombocytopenia, the findings should have no impact on the clinical use of vancomycin."
"Instead," he says, "clinicians administering vancomycin should be alert to the fact that it can cause severe immune thrombocytopenia and have their patient seen by a hematology consultant if they develop a low platelet count while under treatment with the drug. If there's a question, the physician should substitute another antibiotic for vancomycin for a few days to see if the platelet count improves."
Dr. Aster's team will continue to study patients with vancomycin-induced immune thrombocytopenia as they are encountered.
"The real lessons, though, will be learning more about how drugs such as vancomycin trigger the production of antibodies that destroy red and white blood cells in addition to platelets. We also hope to find out how the drugs cause this type of antibody to bind to blood cells and cause their destruction. A longer-term goal is to develop ways to identify environmental and genetic factors that predispose individuals to experience this type of drug hypersensitivity reaction," says Dr. Aster.
Toranj Marphetia | EurekAlert!
A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg
Urbanization to convert 300,000 km2 of prime croplands
27.12.2016 | Mercator Research Institute on Global Commons and Climate Change (MCC) gGmbH
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).
Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...
10.01.2017 | Event News
09.01.2017 | Event News
05.01.2017 | Event News
18.01.2017 | Power and Electrical Engineering
18.01.2017 | Materials Sciences
18.01.2017 | Life Sciences