Department of Pulmonary Medicine, Dr. RP Govt. Medical College, Kangra at Tanda, Himachal Pradesh, India.
Indian J Pharmacol. 2013 Jul-Aug;45(4):405-7. doi: 10.4103/0253-7613.114998.
A 32-year-old male patient was diagnosed as having pulmonary tuberculosis and put on category II antitubercular regime since he had a history of antituberculosis treatment 10 years ago. Within 3 weeks, patient presented with ulcers in mouth, and blood picture confirmed thrombocytopenia. Rifampicin-induced thrombocytopenia was suspected and antitubercular treatment stopped. Patient improved and was re-exposed to the drugs one by one. After re-exposure with pyrazinamide, the platelet count decreased drastically and oral mucosal ecchymoses reappeared, while with rifampicin, thrombocytopenia was accompanied with petechiae on legs and forearms. Isoniazid, ethambutol, and streptomycin were continued.
一位 32 岁男性患者，因曾有 10 年前抗结核治疗史，被诊断为肺结核，给予 II 类抗结核方案治疗。治疗 3 周后，患者出现口腔溃疡，血象提示血小板减少。考虑利福平所致血小板减少症，停用抗结核药物。患者症状改善，逐一再次用药。再次使用吡嗪酰胺后，血小板计数明显下降，口腔黏膜瘀点再次出现，而利福平则伴有小腿和前臂瘀点。异烟肼、乙胺丁醇和链霉素继续使用。
