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Metabolite‐specific (IgG) and drug‐specific antibodies (IgG, IgM) in two cases of trimethoprim‐sulfamethoxazole‐induced immune thrombocytopenia
Author(s) -
Kiefel V.,
Santoso S.,
Schmidt S.,
Salama A.,
MuellerEckhardt C.
Publication year - 1987
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1987.27387235635.x
Subject(s) - antibody , trimethoprim , sulfamethoxazole , metabolite , drug , platelet , serology , immunology , immune system , medicine , urine , pharmacology , chemistry , antibiotics , biochemistry
Two cases of trimethoprim‐sulfamethoxazole (TMP‐SMX)‐induced immune thrombocytopenia are reported in which unusual drug‐dependent platelet antibodies were demonstrated by immunofluorescence and enzyme‐linked immunosorbent assay. Whereas two distinct sulfamethoxazole‐dependent antibodies of the IgG and IgM class were detectable in the serum of one patient, the serum of the other patient contained a platelet antibody exclusively reactive with N‐4‐acetyl‐sulfamethoxazole, a metabolite of sulfamethoxazole. Urine from a healthy volunteer collected after administration of therapeutic doses of TMP‐SMX proved to be an appropriate source of ex vivo metabolites for antibody testing. The results of this study stress the role of metabolite‐specific antibodies in drug‐dependent immune thrombocytopenia and underscore the necessity of including metabolite preparations of drugs in serologic analyses.