替加环素相关性低纤维蛋白原血症：一例病例报告及文献复习
Tigecycline-associated hypofibrinogenemia: A case report and review of the literature.
作者信息
Wu Pei-Chun, Wu Chien-Chih
机构信息
Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, 7 Chung Shan S. Rd., Taipei, Taiwan.
School of Pharmacy, College of Medicine, National Taiwan University, 33 Linsen South Road, Taipei, Taiwan.
出版信息
IDCases. 2018 Jan 12;11:56-57. doi: 10.1016/j.idcr.2018.01.003. eCollection 2018.
Tigecycline, a glycylcycline-derived antibacterial that has been approved for the treatment of various infections, is widely used for multi-drug resistant bacteria. Coagulopathy is an uncommon side effect during tigecycline treatment and is easily overlooked when it occurs. We reported the effect of tigecycline (50 mg every twelve hours) treatment in an 87-year-old man, with Gram negative bacillary pneumonia and respiratory failure. After 7 days of tigecycline treatment, a significant drop of hemoglobin and patchy ecchymosis over both thighs were suddenly observed despite stable clinical condition. There was no abnormality in his platelet count and coagulation profile except for low fibrinogen level. Ecchymosis and anemia subsided gradually after blood component therapy. Although his clinical condition improved, hypofibrinogenemia persisted and recovered after 5 days of tigecycline discontinuation, suggesting probable tigecycline associated hypofibrinogenemia.
替加环素是一种已被批准用于治疗各种感染的甘氨酰环素类抗菌药物，广泛应用于多重耐药菌感染的治疗。凝血功能障碍是替加环素治疗期间罕见的副作用，发生时很容易被忽视。我们报告了替加环素（每12小时50毫克）治疗一名87岁男性革兰氏阴性杆菌肺炎合并呼吸衰竭的效果。替加环素治疗7天后，尽管临床状况稳定，但突然发现血红蛋白显著下降，双侧大腿出现片状瘀斑。除纤维蛋白原水平较低外，其血小板计数和凝血指标均无异常。血液成分治疗后，瘀斑和贫血逐渐消退。尽管他的临床状况有所改善，但低纤维蛋白原血症持续存在，在停用替加环素5天后恢复，提示可能为替加环素相关的低纤维蛋白原血症。
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