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Although vancomycin has been associated with thrombocytopenia, definitive evidence of an immune-based mechanism has been lacking. Researchers now report flow cytometric evidence of vancomycin-dependent, platelet-reactive IgG or IgM antibodies in serum from 29 patients with histories suggestive of vancomycin-related immune thrombocytopenia. (These antibodies were not found in 25 patients given vancomycin who did not develop thrombocytopenia, or in 10 patients with quinine-induced immune thrombocytopenia. IgM antibody was found in 1 of 451 healthy blood donors.)
Patients with the antibodies had clinical histories fairly typical of drug-induced immune thrombocytopenia, with a mean 8 days of vancomycin treatment before reaching a mean nadir plat…