A Case of Vancomycin-Induced Immune Thrombocytopenia.

Vancomycin-induced immune thrombocytopenia (ITP) is a rare, potentially life-threatening complication from an antibiotic frequently used in medical practice. We report a case of an 81-year-old male with recent removal of an infected right knee prosthesis and insertion of an articulating antibiotic spacer, presenting from rehabilitation for severe thrombocytopenia (1 X 103/µL). The patient\u27s thrombocytopenia was initially falsely attributed to rifampin-induced ITP, a much more common cause of drug-induced thrombocytopenia. Only later, after a second precipitous drop in platelet count, vancomycin was correctly identified as the culprit. The patient\u27s serum was tested for drug-dependent platelet antibodies with and without vancomycin. A positive reaction for IgG was detected by flow cytometry in the absence of vancomycin, which was potentiated in the presence of vancomycin. The result indicated the presence of vancomycin-dependent and nondrug-dependent platelet reactive antibodies and confirmed the diagnosis of vancomycin-induced ITP. In this case, the correct diagnosis was masked by the simultaneous administration of two drugs that cause drug-induced ITP and highlights the importance of early recognition of rare, vancomycin-induced ITP

Static and Dynamic Magnetism in Underdoped Superconductor BaFe1.92_{1.92}Co0.08_{0.08}As2_2

We report neutron scattering measurements on single crystals of BaFe$_{1.92}$Co$_{0.08}$As$_2$. The magnetic Bragg peak intensity is reduced by 6 % upon cooling through T$_C$. The spin dynamics exhibit a gap of 8 meV with anisotropic three-dimensional (3d) interactions. Below T$_C$ additional intensity appears at an energy of $\sim$4.5(0.5) meV similar to previous observations of a spin resonance in other Fe-based superconductors. No further gapping of the spin excitations is observed below T$_C$ for energies down to 2 meV. These observations suggest the redistribution of spectral weight from the magnetic Bragg position to a spin resonance demonstrating the direct competition between static magnetic order and superconductivity.Comment: 4 pages, 4 figure

Reticulocyte hemoglobin equivalent (Ret He) and assessment of iron-deficient states

Direct measurement of the reticulocyte hemoglobin content provides useful information for the diagnosis and treatment of iron-deficient states. We have examined direct measurements of reticulocyte and red cell hemoglobin content on the Sysmex XE 2100 (Ret He and RBC He respectively) and the Bayer ADVIA 2120 (CHr and CH respectively) analyzers. Good agreement was found between Ret He and CHr (Y = 1.04X − 1.06; r(2) = 0.88) and between the RBC He and CH parameters (Y = 0.93X + 1; r(2) = 0.84 n = 200) in pediatric patients and in normal adults (Ret He and CHr; Y = 1.06X − 0.43; r(2) = 0.83; n = 126; RBC He and CH; Y = 0.94X + 1; r(2) = 0.87; n = 126). In 1500 blood samples from patients on chronic dialysis, Ret He was compared with traditional parameters for iron deficiency (serum iron <40 μg/dl, Tsat <20%, ferritin <100 ng/ml, hemoglobin <11 g/dl) for identifying iron-deficient states. Receiver operator characteristic (ROC) curve analysis revealed values of the area under the curve for Ret He of 0.913 (P < 0.0001). With a Ret He cutoff level of 27.2 pg, iron deficiency could be diagnosed with a sensitivity of 93.3%, and a specificity of 83.2%. Ret He is a reliable marker of cellular hemoglobin content and can be used to identify the presence of iron-deficient states

Transient and permanent effects of suboptimal incubation temperatures on growth, metabolic rate, immune function and adrenocortical responses in zebra finches

n birds, incubation temperature can vary by several degrees Celsius among nests of a given species. Parents may alter incubation temperature to cope with environmental conditions and/or to manipulate embryonic development, and such changes in incubation behavior could have long-lasting effects on offspring phenotype. To investigate short- and long-term effects of suboptimal incubation temperatures on survival and physiological functions in zebra finches, eggs were incubated at 36.2, 37.4 or 38.4°C for the entire incubation period. The post-hatch environment was identical among the treatment groups. We found that hatching success was lowest in the 38.4°C group, while post-hatch survival was lowest in the 36.2°C group. Incubation temperature had sex-specific effects on offspring phenotype: incubation temperatures affected body mass (Mb) but not physiological parameters of males and conversely, the physiological parameters but not Mb of females. Specifically, males from the 38.4°C group weighed significantly less than males from the 36.2°C group from the nestling period to adulthood, whereas females from different incubation temperature groups did not differ in Mb. In contrast, females incubated at 36.2°C had transient but significantly elevated basal metabolic rate and adrenocortical responses during the nestling and fledgling periods, whereas no treatment effect was observed in males. Innate immunity was not affected by incubation temperature in either sex. These results suggest that a 1°C deviation from what is considered an optimal incubation temperature can lower offspring performance and offspring survival.Publisher PDFPeer reviewe