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[氨苯砜引起的粒细胞缺乏症。附3例报告并文献复习]

[Agranulocytosis caused by dapsone. Apropos of 3 cases. Review of the literature].

作者信息

Liozon F, Fourgnaud-Gaillard S, Bordessoule D, Rousset H, Vidal E, Weinbreck P, Liozon E, Cransac M

机构信息

Service de Médecine Interne A, C.H.U. Limoges.

出版信息

Ann Med Interne (Paris). 1988;139(7):469-75.

PMID:3072892
Abstract

Authors describe three cases of agranulocytosis in patients with giant cell (temporal) arterities treated with Dapsone and corticosteroids. The culture in vitro of CFU.GM. cells of two patients, four healthy subject and two patients treated with Dapsone with out granulopenia, demonstrates no any toxic effect of Dapsone. A review of the literature finds 59 cases of agranulocytosis in patients treated with Dapsone alone or in combination with other drugs. Doses of Dapsone ranged from 25 mg to 300 mg a day. Agranulocytosis occurred between the 4th and the 12th week, more often near the 8th week. Agranulocytosis occurred suddenly without previous granulocytopenia. These facts argue for immunoallergic mechanism. This Dapsone side effect requires to restrict its use and to reserve it to serious diseases or failures of other therapeutic drugs. It needs too to keep a close eye on the patients between the 6th and 12th week.

摘要

作者描述了3例巨细胞(颞)动脉炎患者在使用氨苯砜和皮质类固醇治疗过程中出现粒细胞缺乏症的情况。对2例患者、4名健康受试者以及2例使用氨苯砜但未出现粒细胞减少症的患者的粒系集落形成单位(CFU.GM)细胞进行体外培养,结果显示氨苯砜无任何毒性作用。文献回顾发现,59例患者在单独使用氨苯砜或与其他药物联合使用时出现了粒细胞缺乏症。氨苯砜的剂量范围为每日25毫克至300毫克。粒细胞缺乏症发生在第4周至第12周之间,多在第8周左右。粒细胞缺乏症突然发生,之前并无粒细胞减少。这些事实支持免疫过敏机制。氨苯砜的这种副作用要求限制其使用,仅用于严重疾病或其他治疗药物无效的情况。同时,在第6周至第12周期间需要密切关注患者。

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