喹硫平相关的白细胞减少症和血小板减少症：一例报告。
Quetiapine-associated leucopenia and thrombocytopenia: a case report.
作者信息
Fan Kuang-Yuan, Chen Wen-Yin, Huang Ming-Chyi
机构信息
Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Taipei, Taiwan.
Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
出版信息
BMC Psychiatry. 2015 May 7;15:110. doi: 10.1186/s12888-015-0495-9.
BACKGROUND
There have been few reports regarding quetiapine-associated hematological effects other than white-blood-cell alteration. We present the first reported Han-Chinese case that developed leucopenia and thrombocytopenia after taking quetiapine.
CASE PRESENTATION
We present a case of a person with a bipolar I disorder who experienced leucopenia and thrombocytopenia after taking 400 mg/day of quetiapine and 1000 mg/day of valproic acid for three and one-half months. The hematological toxicity abated upon the discontinuation of both drugs. However, due to the intolerable side effects of the replaced antipsychotic (haloperidol), and according to the patient's preference, we prescribed quetiapine and valproic acid again. There was a recurrence of leucopenia and a decreased platelet count by the sixth day. The adverse effects disappeared soon after we discontinued quetiapine, while keeping valproic acid treatment.
CONCLUSION
Quetiapine-associated leucopenia and thrombocytopenia seems reversible but possibly fatal. Therefore, clinical practitioners should be aware of this adverse reaction.
背景
除白细胞改变外，关于喹硫平相关血液学影响的报道较少。我们报告首例服用喹硫平后出现白细胞减少和血小板减少的汉族病例。
病例报告
我们报告一例双相I型障碍患者，服用每日400毫克喹硫平和每日1000毫克丙戊酸三个半月后出现白细胞减少和血小板减少。停用两种药物后血液学毒性减轻。然而，由于替代抗精神病药物（氟哌啶醇）难以耐受的副作用，且根据患者的偏好，我们再次开具了喹硫平和丙戊酸。到第六天白细胞减少复发且血小板计数下降。停用喹硫平同时继续丙戊酸治疗后，不良反应很快消失。
结论
喹硫平相关的白细胞减少和血小板减少似乎是可逆的，但可能致命。因此，临床医生应意识到这种不良反应。
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