Teicoplanin‐dependent antibodies: detection and characterization

Abstract

Summary There are only a few reports of thrombocytopenia associated with clinical doses of teicoplanin, a glycopeptide antibiotic used against Gram‐positive bacteria. We investigated 39 patients receiving teicoplanin; 31 were thrombocytopenic with platelet counts between 1–105 × 109/l and 8 were not thrombocytopenic. We identified 14 thrombocytopenic cases (45%) and two (25%) non‐thrombocytopenic cases with IgG teicoplanin‐dependent platelet‐reactive antibodies. Use of glycoprotein (GP) capture enzyme‐linked immunosorbent assay with platelets and GPIIb/IIIa transfected Chinese Hamster Ovary cells as well as flow cytometry with GP‐deficient platelets indicated that the GPIIb/IIIa complex is a major target antigen of these antibodies.

Comparative Evaluation of Linezolid and Teicoplanin in the Treatment of Ventilator-Associated MRSA Pneumonia: A Single-Center Experience

“…IIb/IIIa (GPIIb/IIIa) available on platelet cells, and rarely caused thrombocytopenia when the antibodies were clinically significant (32). A systemic review and meta-analysis found less frequent teicoplanin-induced nephrotoxicity (elevated serum creatinine level from the baseline value) (RR, 0.44; 95% CI, 0.32 to 0.61), and teicoplanin-induced acute interstitial nephritis leading to irreversible nephrotoxicity was first reported in 1992 (33).…”

A Case of Vancomycin-Induced Thrombocytopenia

“…A recent reports indicate that many antibiotic drugs such as teicoplanin and quinine can also cause immune thrombocytopenia. [8][9][10] In this patient, the antibody reacted with the platelets only when vancomycin was administered, not Tazocin. However, in some previously reported cases, there was no evidence of the presence DDPA.…”

Flow cytometry in the diagnosis of drug‐induced thrombocytopenia: Two illustrative cases

“…Drug binding to platelet surface can form a new epitope or cause the exposure of a neo-epitope. Glycoprotein Ib-IX and GP IIb/IIIa are most frequently involved in drug binding, which leads to the formation of new epitopes that appear to be very specific for each different drug [6][7][8][9][10][11][12][13][14]. The development of drug-dependent antiplatelet antibodies may thus cause accelerated platelet clearance in vivo and induce severe thrombocytopenia.…”

“…An immunological mechanism is postulated for many drugs, but so far there is clear evidence of drugdependent antiplatelet antibodies only for a few of them (rifampicin, abciximab, quinine, ranitidine, vancomycin, teicoplanin, sulfonamide, tamoxifene, heparin, and few others) [2,[6][7][8][9][10][11][12][13][14][15][16]. Drug binding to platelet surface can form a new epitope or cause the exposure of a neo-epitope.…”