重症监护病房中哌拉西林/他唑巴坦诱导的免疫介导性血小板减少症。
Piperacillin/tazobactam-induced immune-mediated thrombocytopenia in the intensive care unit.
作者信息
Boyce K, Brar H, Stabler S N
机构信息
Department of Critical Care and Department of Pharmacy Services, Surrey Memorial Hospital, Surrey, BC, Canada.
出版信息
J Clin Pharm Ther. 2016 Dec;41(6):730-732. doi: 10.1111/jcpt.12458. Epub 2016 Sep 27.
WHAT IS KNOWN AND OBJECTIVE
Drug-induced immune-mediated thrombocytopenia is a rare adverse event that remains a diagnostic challenge, especially in the critically ill population. There are only two previously reported cases of rapid and profound thrombocytopenia after administration of piperacillin/tazobactam.
CASE SUMMARY
A 64-year-old man experienced several episodes of isolated thrombocytopenia after receiving piperacillin/tazobactam. Interestingly, the degree of thrombocytopenia varied with the amount of corticosteroid therapy the patient was receiving. Due to the complexity of thrombocytopenia in critically ill patients, other potential causes were extensively worked up and ruled out.
WHAT IS NEW AND CONCLUSION
We describe the first case of piperacillin/tazobactam-induced immune-mediated thrombocytopenia that was mitigated by the administration of corticosteroid therapy. This case highlights the importance of identifying potential drug-related causes of isolated thrombocytopenia.
已知信息与目的
药物诱导的免疫介导性血小板减少症是一种罕见的不良事件，仍然是一个诊断难题，尤其是在重症患者群体中。此前仅有两例关于使用哌拉西林/他唑巴坦后出现快速且严重血小板减少症的报道病例。
病例摘要
一名64岁男性在接受哌拉西林/他唑巴坦治疗后出现了数次孤立性血小板减少症发作。有趣的是，血小板减少的程度随患者接受的皮质类固醇治疗量而变化。由于重症患者血小板减少情况复杂，对其他潜在病因进行了广泛排查并排除。
新发现与结论
我们描述了首例经皮质类固醇治疗缓解的哌拉西林/他唑巴坦诱导的免疫介导性血小板减少症病例。该病例凸显了识别孤立性血小板减少症潜在药物相关病因的重要性。
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