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Meropenem‐induced immune thrombocytopenia and the diagnostic process of laboratory testing
Author(s) -
Huang Rong,
Cai GuangQing,
Zhang JunHua,
Liu FengXia,
Ma JinQi,
Liu Hong,
Nie XinMin,
Gui Rong
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14267
Subject(s) - medicine , meropenem , antibody , immunoassay , immunology , antigen , monoclonal antibody , immune system , antibiotics , microbiology and biotechnology , antibiotic resistance , biology
BACKGROUND Drug‐induced immune thrombocytopenia (DITP) is a serious, life‐threatening clinical syndrome, the diagnosis of which is consistently difficult. In this report, we present a case of DITP caused by meropenem that was confirmed by laboratory tests. CASE REPORT A 59‐year‐old male patient developed severe thrombocytopenia 8 days after the administration of meropenem and cefoperazone‐sulbactam. After other causes were ruled out, DITP was suspected. Drug‐induced platelet (PLT) antibodies were detected by enzyme immunoassay, flow cytometry, and monoclonal antibody immobilization of PLT antigens (MAIPA). All these tests were performed in the presence and absence of the associated drugs. RESULTS PLT antibodies were detected in the patient's serum only in the presence of meropenem. MAIPA experiments demonstrated that glycoprotein IIb/IIIa was the binding site of the meropenem‐induced PLT antibodies. CONCLUSIONS Drug‐induced immune thrombocytopenia should be considered in cases of acute thrombocytopenia in patients undergoing meropenem treatment. Clinicians should be cognizant of DITP, and a definitive diagnosis should be pursued, if feasible.