Ciprofloxacin/β-lactams
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Reactions 1128 - 18 Nov 2006 Ciprofloxacin/β-lactams Factor V inhibitor development in an elderly patient:? case report A 72-year-old man experienced factor V inhibitor development during treatment with ciprofloxacin and β- lactams. The man was hospitalised with intraparenchymal haemorrhage and intraventricular haemorrhage, and a ventricular drain was placed; at this time, he had normal activated partial thromboplastin time (aPTT) and prothrombin time (PT). A few days after the surgery, he developed spontaneous intraparenchymal lung haemorrhage of unknown origin. One week postsurgery, he started receiving ciprofloxacin and β-lactams [dosages not stated; specific β- lactams not stated] because his sputum cultures were positive for Enterobacter species. Two weeks after neurosurgical intervention, his aPTT and PT prolonged progressively. After receiving fresh frozen plasma on hospital days 17–19, the man started receiving cyclophosphamide and corticosteroids. On day 21, his aPTT was 164.7 seconds (reference 25–36) and his PT was 17% (100%–120%). At that time, his intrapulmonal [sic] and intracranial haemorrhages had resolved. Laboratory investigations revealed the presence of a factor V inhibitor and a factor V activity of 1%; his factor V inhibitor activity was 48 Bethesda units/mL. Two weeks after inhibitor discovery, his factor V level was 11% and his inhibitor titre was 0.75 Bethesda units/mL. One month after inhibitor discovery, his factor V level was 135%, and his aPTT and PT had normalised. His immunosuppressive treatment was continued for 1 month after inhibitor elimination. Author comment: In the first place, the man’s factor V inhibitor development could have been triggered by his pulmonary infection. Secondly, both ciprofloxacin and β- lactams could be the cause of inhibitor development. His postoperative status could also be responsible for inhibitor development. Leus B, et al. Factor V inhibitor: case report. Blood Coagulation and Fibrinolysis 17: 585-587, No. 7, Oct 2006 - Belgium 801013771 1 Reactions 18 Nov 2006 No. 1128 0114-9954/10/1128-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Ciprofloxacin/β-lactams
Reactions 1128 - 18 Nov 2006
Ciprofloxacin/β-lactams
Factor V inhibitor development in an elderlypatient:? case report
A 72-year-old man experienced factor V inhibitordevelopment during treatment with ciprofloxacin and β-lactams.
The man was hospitalised with intraparenchymalhaemorrhage and intraventricular haemorrhage, and aventricular drain was placed; at this time, he had normalactivated partial thromboplastin time (aPTT) and prothrombintime (PT). A few days after the surgery, he developedspontaneous intraparenchymal lung haemorrhage of unknownorigin. One week postsurgery, he started receivingciprofloxacin and β-lactams [dosages not stated; specific β-lactams not stated] because his sputum cultures were positivefor Enterobacter species. Two weeks after neurosurgicalintervention, his aPTT and PT prolonged progressively.
After receiving fresh frozen plasma on hospital days 17–19,the man started receiving cyclophosphamide andcorticosteroids. On day 21, his aPTT was 164.7 seconds(reference 25–36) and his PT was 17% (100%–120%). At thattime, his intrapulmonal [sic] and intracranial haemorrhageshad resolved. Laboratory investigations revealed the presenceof a factor V inhibitor and a factor V activity of 1%; his factor Vinhibitor activity was 48 Bethesda units/mL. Two weeks afterinhibitor discovery, his factor V level was 11% and his inhibitortitre was 0.75 Bethesda units/mL. One month after inhibitordiscovery, his factor V level was 135%, and his aPTT and PThad normalised. His immunosuppressive treatment wascontinued for 1 month after inhibitor elimination.
Author comment: In the first place, the man’s factor Vinhibitor development could have been triggered by hispulmonary infection. Secondly, both ciprofloxacin and β-lactams could be the cause of inhibitor development. Hispostoperative status could also be responsible for inhibitordevelopment.Leus B, et al. Factor V inhibitor: case report. Blood Coagulation and Fibrinolysis17: 585-587, No. 7, Oct 2006 - Belgium 801013771
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Reactions 18 Nov 2006 No. 11280114-9954/10/1128-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
