全血细胞减少症发生后丙戊酸的成功重新引入。
Successful reintroduction of valproic acid after the occurrence of pancytopenia.
作者信息
Stewart Jonathan T
机构信息
James A. Haley VA Hospital, Tampa, Florida 33612, USA.
出版信息
Am J Geriatr Pharmacother. 2011 Oct;9(5):351-3. doi: 10.1016/j.amjopharm.2011.09.003. Epub 2011 Oct 2.
BACKGROUND
Valproic acid is associated with a variety of hematologic abnormalities, most commonly thrombocytopenia. Pancytopenia is much less common and potentially much more serious. Little is known about the natural course of valproate-induced pancytopenia.
CASE SUMMARY
We present a patient who developed pancytopenia while taking valproic acid for bipolar illness. After failing to respond to several other mood stabilizers, valproic acid was cautiously reintroduced with close hematologic monitoring. The pancytopenia has not recurred in the past 6 months.
CONCLUSIONS
Pancytopenia may not represent an absolute contraindication to continuing valproate therapy, although caution is warranted.
背景
丙戊酸与多种血液学异常有关，最常见的是血小板减少症。全血细胞减少症则较为少见，但可能严重得多。关于丙戊酸盐所致全血细胞减少症的自然病程，人们了解甚少。
病例摘要
我们报告一名双相情感障碍患者，在服用丙戊酸期间出现了全血细胞减少症。在对其他几种心境稳定剂治疗无效后，在密切的血液学监测下谨慎地重新启用了丙戊酸。全血细胞减少症在过去6个月中未再复发。
结论
全血细胞减少症可能并不绝对意味着继续丙戊酸盐治疗的禁忌证，尽管仍需谨慎。
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