Josol Cindy V, Buenaluz-Sedurante Myrna, Sandoval Mark Anthony, Castillo Gerry
Medicine Department, University of the Philippines Philippine General Hospital, Manila, Philippines.
BMJ Case Rep. 2010 Dec 20;2010:bcr0520102993. doi: 10.1136/bcr.05.2010.2993.
A 55-year-old Filipina with Grave's disease, diabetes, hypertension, bronchial asthma, Parkinson's disease and a history of adverse drug reaction to penicillin consulted due to high-grade fever and sore throat. Patient was diagnosed with aplastic anaemia secondary to methimazole and was treated with high-dose granulocyte colony stimulating factor, thrombopoietin and mesterolone. Antibiotics used included levofloxacin, clindamycin, amikacin and fluconazole. Due to bleeding and slow recovery of blood parameters, 30 units of platelets and 7 units of packed red blood cells were transfused during her 22-day admission. This case presents a life-threatening adverse drug reaction in a patient with co-morbid conditions that complicate recovery and limit one's therapeutic options.
一名55岁的菲律宾女性，患有格雷夫斯病、糖尿病、高血压、支气管哮喘、帕金森病，并有青霉素药物不良反应史，因高热和喉咙痛前来咨询。患者被诊断为甲巯咪唑继发的再生障碍性贫血，并接受了高剂量粒细胞集落刺激因子、血小板生成素和美睾酮治疗。使用的抗生素包括左氧氟沙星、克林霉素、阿米卡星和氟康唑。由于出血和血液参数恢复缓慢，在她住院的22天里输注了30单位血小板和7单位浓缩红细胞。该病例呈现了一名患有多种合并症患者出现的危及生命的药物不良反应，这些合并症使恢复复杂化并限制了治疗选择。
