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Four California women have died from a bloodstream infection after using the controversial abortion pill RU-486. All were caused by sepsis, a bloodstream infection, although the women didn't have all the usual symptoms for sepsis, such as fever, health officials say. Sold as Mifeprex, and also known as RU-486 or mifepristone, the drug is taken as two pills at different times. More than 460,000 women in the United States have used Mifeprex since it was invented in France in the 1980s. The pill already contains a "black-box" warning highlighting the risk of bacterial infection, sepsis and death. Two of the infections were caused by a common bacterium called Clostridium sordellii, which can cause nausea and diarrhea, but is rarely fatal. Investigators are studying how the germ might have mutated and become more lethal. Monty Patterson, whose 18-year-old daughter Holly died of septic shock after taking Mifeprex to end an unplanned pregnancy in 2003, said the pill should be pulled from the market. Patterson has been lobbying to halt sale of the pill since Holly's death, which was the first of the four California cases to be reported to the FDA. Dr. Ralph Miech, M.D. of the Medical School at Brown University, has stated the following after a study of the drug: "Mifepristone, by blocking both progesterone and glucocorticoid receptors, interferes with the controlled release and functioning of cortisol and cytokines. Failure of physiologically controlled cortisol and cytokine responses results in an impaired innate immune system that results in disintegration of the body's defense system necessary to prevent the endometrial spread of Clostridium sordellii infection. The abnormal cortisol and cytokine responses due to mifepristone coupled to the release of potent exotoxins and an endotoxin from Clostridium sordellii are the major contributors to the rapid development of lethal septic shock. |