Munir Farrukh, Javaid Hafiza Wajeeha, Rana Muhammad Burhan Majeed, Shaukat Fatima
Internal Medicine, WellSpan York Hospital, York, USA.
Internal Medicine, Queens Hospital Center, New York, USA.
Cureus. 2022 Mar 16;14(3):e23226. doi: 10.7759/cureus.23226. eCollection 2022 Mar.
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.
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。