Division of Clinical Pharmacology and Toxicology, University and University Hospital Basel, Switzerland.
Division of Haematology, University Hospital Basel, Switzerland.
Swiss Med Wkly. 2020 Dec 30;147:w14438. doi: 10.4414/smw.2020.14438. eCollection 2017 May 22.
The aim of this study was to identify possible risk factors for the development of leucopenia associated with metamizole use.
A retrospective case-control study was performed. Cases of metamizole-associated leucopenia managed at a single centre (2005-2013) were characterised and compared with matched controls who took metamizole without developing complications.
Fifty-seven cases and 139 controls were identified. Of the cases, 32 were postoperative and these were compared to age-, sex- and ward-matched postoperative controls (n = 64). The remaining cases (n = 25) were compared to sex-matched, non-postoperative controls (n = 75). The number of patients with a positive allergy history was higher among postoperative cases than controls (p = 0.004) as was the number with previous leucopenic episodes (p = 0.03). The prevalence of diagnosed hepatitis C infection was 9% among all cases compared with 1% among all controls (p = 0.005). The use of concomitant cytostatic agents (even at immunosuppressive doses) was significantly higher among non-postoperative cases than controls (p = 0.011). There was no association between renal function and the development of leucopenia.
A history of allergies, previous leucopenic episodes, hepatitis C infection and concomitant cytostatic agents are possible risk factors for leucopenia associated with metamizole use.
本研究旨在确定与使用甲灭酸相关的白细胞减少症的可能危险因素。
进行了一项回顾性病例对照研究。对在一个中心（2005-2013 年）治疗的与甲灭酸相关的白细胞减少症病例进行了特征描述，并与未发生并发症而使用甲灭酸的匹配对照者进行了比较。
确定了 57 例病例和 139 例对照者。在这些病例中，32 例为术后患者，将其与年龄、性别和病房相匹配的术后对照组（n = 64）进行比较。其余病例（n = 25）与性别相匹配的非术后对照组（n = 75）进行比较。与对照组相比，术后病例中具有阳性过敏史的患者（p = 0.004）和有过白细胞减少发作史的患者（p = 0.03）更多。所有病例中丙型肝炎感染的患病率为 9%，而所有对照者中为 1%（p = 0.005）。与对照组相比，非术后病例中同时使用细胞毒性药物（即使是免疫抑制剂量）的情况明显更高（p = 0.011）。肾功能与白细胞减少症的发生之间没有关联。
过敏史、既往白细胞减少症发作、丙型肝炎感染和同时使用细胞毒性药物是与使用甲灭酸相关的白细胞减少症的可能危险因素。
