A case report of vancomycin-induced immune thrombocytopenia
10.3760/cma.j.cn441217-20231012-01017
- VernacularTitle:万古霉素致免疫性血小板减少症1例
- Author:
Yuling ZHANG
1
;
Fengmei WANG
;
Yan YANG
;
Bin WANG
;
Xiaoliang ZHANG
Author Information
1. 东南大学医学院，南京 210009
- Keywords:
Renal dialysis;
Vancomycin;
Plasma exchange;
Thrombocytopenia
- From:
Chinese Journal of Nephrology
2024;40(8):667-670
- CountryChina
- Language:Chinese
-
Abstract:
The paper reports a 68-year-old female patient admitted with "recurrent fever for 2 years" with a previous history of chronic kidney disease (stage 5) and receiving maintenance hemodialysis for 2 years. After 15 days of anti-infection treatment with vancomycin, the patient showed a steep drop in peripheral platelet count to <1×10 9/L. Combined with the clinical manifestations and platelet antibody screening, considering vancomycin-induced thrombocytopenia (VIT), vancomycin was immediately stopped, and active plasma exchange was adopted. Finally, the peripheral blood platelet count of the patient returned to normal, supporting the diagnosis of VIT. Vancomycin is widely used in dialysis patients, and the clinicians should be aware of the rare but severe adverse effect of VIT. Once present, vancomycin should be stopped early and individualized treatment should be taken to avoid the risk of massive bleeding or death.
