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万古霉素诱导的免疫性血小板减少症一例罕见病例。

A Rare Case of Vancomycin-Induced Immune Thrombocytopenia.

作者信息

Hameed Maha, Alamri Sultan, Almustanyir Sami

机构信息

College of Medicine, Alfaisal University, Riyadh, SAU.

Critical Care Department, National Care Hospital, Riyadh, SAU.

出版信息

Cureus. 2022 Mar 19;14(3):e23328. doi: 10.7759/cureus.23328. eCollection 2022 Mar.

Abstract

Vancomycin-induced immune thrombocytopenia (ITP) is a rare type of drug-induced immune thrombocytopenia (DITP) that can lead to life-threatening consequences as a result of its use. We herein report a case of a 74-year-old male with a history of diabetes mellitus type II, Alzheimer's disease, and stroke who presented to the ICU with sepsis. The patient was on heparin for 20 days prior to presentation, with platelet levels at the time within normal limits as per his baseline. Following the introduction of vancomycin to his clinical regimen in the treatment of sepsis, the patient developed a significant drop in platelet count from 400 x10³/mm³ to 70 x10³/mm³. Discontinuation of the drug leads to improvement of the platelet counts confirming the diagnosis of vancomycin-induced ITP.

摘要

万古霉素诱导的免疫性血小板减少症(ITP)是一种罕见的药物诱导的免疫性血小板减少症(DITP),使用该药物可能导致危及生命的后果。我们在此报告一例74岁男性病例,该患者有II型糖尿病、阿尔茨海默病和中风病史,因脓毒症入住重症监护病房(ICU)。患者在入院前接受了20天的肝素治疗,当时血小板水平根据其基线处于正常范围内。在临床治疗脓毒症方案中引入万古霉素后,患者血小板计数从400×10³/mm³显著降至70×10³/mm³。停用该药物后血小板计数有所改善,从而确诊为万古霉素诱导的ITP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2e4/9015062/838b8649edc5/cureus-0014-00000023328-i01.jpg

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