一名美国原住民中氯氮平诱发的粒细胞缺乏症：HLA分型及对免疫介导机制的进一步支持
Clozapine-induced agranulocytosis in a Native American: HLA typing and further support for an immune-mediated mechanism.
作者信息
Pfister G M, Hanson D R, Roerig J L, Landbloom R, Popkin M K
机构信息
St. Paul Ramsey Medical Center, Department of Psychiatry, MN 55101-2595.
出版信息
J Clin Psychiatry. 1992 Jul;53(7):242-4.
BACKGROUND
Approximately 30% of schizophrenic patients defined as treatment refractory significantly improve with clozapine. However, clozapine produces agranulocytosis in approximately 1% to 2% of patients in the United States. The mechanism of clozapine-induced agranulocytosis has not been established, but evidence suggests an immune-mediated mechanism.
METHOD
Human leukocyte antigen (HLA) typing was performed in a native American with clozapine-induced agranulocytosis.
RESULTS
Our findings support previous observations of a role of the HLA-B16, DR4, DQw3 haplotype in predicting susceptibility to agranulocytosis in clozapine-treated patients.
CONCLUSION
We suggest that HLA typing of clozapine candidates may be useful for predicting the risk for clozapine-induced agranulocytosis.
背景
约30%被定义为难治性的精神分裂症患者使用氯氮平后有显著改善。然而，在美国约1%至2%的患者使用氯氮平会出现粒细胞缺乏症。氯氮平诱导粒细胞缺乏症的机制尚未明确，但有证据表明是一种免疫介导机制。
方法
对一名使用氯氮平后出现粒细胞缺乏症的美国原住民进行了人类白细胞抗原（HLA）分型。
结果
我们的研究结果支持了之前关于HLA - B16、DR4、DQw3单倍型在预测氯氮平治疗患者粒细胞缺乏症易感性方面作用的观察。
结论
我们建议对氯氮平候选者进行HLA分型可能有助于预测氯氮平诱导粒细胞缺乏症的风险。
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