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头孢曲松诱导的可逆性粒细胞缺乏症:一例报告及药物性粒细胞缺乏症综述

Ceftriaxone-Induced Reversible Agranulocytosis: A Case Report and Review of Drug-Induced Agranulocytosis.

作者信息

Munir Farrukh, Javaid Hafiza Wajeeha, Rana Muhammad Burhan Majeed, Shaukat Fatima

机构信息

Internal Medicine, WellSpan York Hospital, York, USA.

Internal Medicine, Queens Hospital Center, New York, USA.

出版信息

Cureus. 2022 Mar 16;14(3):e23226. doi: 10.7759/cureus.23226. eCollection 2022 Mar.

Abstract

In the modern era of medicine, agranulocytosis is a rare occurrence. Despite significant improvement in patient survival, it still carries significant mortality. Agranulocytosis is most commonly caused by chemotherapeutic agents and numerous non-chemo drugs. As it can develop anytime during treatment and patients can remain asymptomatic, frequent cell count monitoring is an essential tool to make a timely diagnosis. An appropriate drug switch, work up to rule out infection and granulocyte colony-stimulating factor (G-CSF) injection in high-risk cases is the management. The patient should be kept under observation till the resolution of agranulocytosis. We present a case of ceftriaxone-induced agranulocytosis which was completely reversible upon stoppage of drug and granulocyte colony-stimulating factor administration. The pathogenesis of ceftriaxone-induced agranulocytosis is unknown. It is suggested to occur either by an immunologic mechanism or because of direct drug toxicity.

摘要

在现代医学时代,粒细胞缺乏症是一种罕见的病症。尽管患者生存率有了显著提高,但它仍具有较高的死亡率。粒细胞缺乏症最常见的病因是化疗药物和众多非化疗药物。由于它可在治疗期间的任何时候发生,且患者可能没有症状,因此频繁进行血细胞计数监测是及时做出诊断的重要手段。管理措施包括适当更换药物、进行检查以排除感染,以及在高危病例中注射粒细胞集落刺激因子(G-CSF)。患者应一直接受观察,直至粒细胞缺乏症消退。我们报告一例头孢曲松诱导的粒细胞缺乏症病例,在停用药物并给予粒细胞集落刺激因子后完全可逆。头孢曲松诱导粒细胞缺乏症的发病机制尚不清楚。有人认为它要么通过免疫机制发生,要么是由于直接的药物毒性。

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Ceftriaxone-induced Agranulocytosis.头孢曲松所致粒细胞缺乏症。
Eur J Case Rep Intern Med. 2021 Jan 8;8(1):002215. doi: 10.12890/2021_002215. eCollection 2021.

本文引用的文献

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Current understanding of the mechanisms of idiosyncratic drug-induced agranulocytosis.目前对药物致特发性粒细胞缺乏症机制的认识。
Expert Opin Drug Metab Toxicol. 2015 Feb;11(2):243-57. doi: 10.1517/17425255.2015.985649. Epub 2014 Nov 26.
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Anticonvulsant drugs and hematological disease.抗癫痫药物与血液系统疾病。
Neurol Sci. 2014 Jul;35(7):983-93. doi: 10.1007/s10072-014-1701-0. Epub 2014 Mar 12.

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