Mukherjee Subhajit, Jana Tanima, Pan Jen-Jung
Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Texas Health Science Center, Houston, TX 77030, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
Case Rep Gastrointest Med. 2018 Apr 30;2018:4294805. doi: 10.1155/2018/4294805. eCollection 2018.
Proton pump inhibitors (PPIs) are the most effective and preferred class of drugs used to treat peptic ulcer disease, gastroesophageal reflux disease, and other diseases associated with increased production of gastric acid. PPIs in general have an excellent long-term safety profile and are well-tolerated. However, studies have shown some adverse reactions (e.g., osteoporosis, -associated diarrhea, Vitamin B12 and iron deficiency, and acute interstitial nephritis) on long-term PPI use. Thrombocytopenia attributed to use of PPIs has been described in a few case reports and a retrospective study. In this case report, we describe a case of PPI-induced thrombocytopenia. In our patient, thrombocytopenia immediately developed after the initiation of PPI on two separate occasions and resolved after its discontinuation. The strong association found in our case implies the potential role of PPI in causing this rare but serious adverse reaction. Based on this case report and the observation from other studies, a PPI-induced adverse event should be considered as a possible etiology for new-onset idiopathic thrombocytopenia.
质子泵抑制剂(PPIs)是治疗消化性溃疡病、胃食管反流病以及其他与胃酸分泌增加相关疾病最有效且首选的药物类别。总体而言,PPIs具有出色的长期安全性,耐受性良好。然而,研究表明长期使用PPIs会出现一些不良反应(如骨质疏松、相关性腹泻、维生素B12和铁缺乏以及急性间质性肾炎)。少数病例报告和一项回顾性研究描述了因使用PPIs导致的血小板减少症。在本病例报告中,我们描述了一例PPIs诱发的血小板减少症。在我们的患者中,两次单独使用PPIs后均立即出现血小板减少症,停药后血小板减少症得以缓解。我们病例中发现的强烈关联意味着PPIs在引发这种罕见但严重的不良反应中可能发挥的作用。基于本病例报告以及其他研究的观察结果,PPIs诱发的不良事件应被视为新发特发性血小板减少症的一种可能病因。