急性医源性粒细胞缺乏症：一例需引起关注的罕见且严重的药物不良反应病例
Acute Iatrogenic Agranulocytosis: A Rare and Dire Case of an Adverse Drug Reaction to Be Aware.
作者信息
André Diogo, Caldeira Mónica, Gouveia Fabiana, Nascimento Rafael, Chaves António, Braza O Maria
机构信息
Hospital Central Do Funchal, Madeira Island, Funchal, Portugal.
出版信息
Case Rep Hematol. 2020 Nov 19;2020:6125626. doi: 10.1155/2020/6125626. eCollection 2020.
BACKGROUND
Iatrogenic agranulocytosis (IA), by nonchemotherapeutic drugs, is a rare adverse event, resulting in a neutrophil count under 0.5 × 10 cells/L with fever or other suggestive signs of infection.
METHODS
This paper discusses the possible mechanisms responsible for agranulocytosis induced by nonchemotherapeutic drugs. It also describes three cases as well as potential ways to handle such iatrogenic situations.
CONCLUSION
Neutropenia under 0.1 × 10 cells/L predispose patients to potentially fatal infections. Empiric broad-spectrum antibiotic and hematopoietic growth factors may be helpful in shortening hospitalization and prevent further infectious complications. Not all drugs associated with IA require frequent hematological monitoring, except medications such as clozapine, ticlopidine, and antithyroids.
背景
非化疗药物引起的医源性粒细胞缺乏症（IA）是一种罕见的不良事件，会导致中性粒细胞计数低于0.5×10⁹细胞/L，并伴有发热或其他感染迹象。
方法
本文讨论了非化疗药物引起粒细胞缺乏症的可能机制。还描述了三个病例以及处理此类医源性情况的潜在方法。
结论
中性粒细胞计数低于0.1×10⁹细胞/L会使患者易发生潜在致命感染。经验性使用广谱抗生素和造血生长因子可能有助于缩短住院时间并预防进一步的感染并发症。并非所有与IA相关的药物都需要频繁进行血液学监测，除了氯氮平、噻氯匹定和抗甲状腺药物等。
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