Assyag P, Koenig A, Fass H, Brechenmacher C
Ann Cardiol Angeiol (Paris). 1987 Feb;36(2):81-3.
Captopril, an inhibitor of the conversion enzyme, is a medication with a known efficacy in the treatment of arterial hypertension and congestive cardiac insufficiency. Its side-effects are few. Among them, agranulocytosis is a severe complication, all the more severe and frequent as it occurs in patients with chronic renal insufficiency, collagen disease, or patient treated with medication having a leucopenic potential. Our case reports an agranulocytosis secondary to captopril in a patient with cardiac insufficiency presenting none of these aggravating factors. The mechanism of agranulocytosis secondary to captopril remains currently debatable, but does not seem, in the present case, to be dose related. Thus, a captopril prescription must comply with certain rules; decrease of the dosage in case of renal insufficiency, usual precautions in patients with collagene diseases. The association to a medication with leucopenic potential is to be avoided. Hematologic monitoring will be adapted to each particular case.
卡托普利是一种转换酶抑制剂，是一种在治疗动脉高血压和充血性心力衰竭方面具有已知疗效的药物。其副作用较少。其中，粒细胞缺乏症是一种严重的并发症，在慢性肾功能不全、胶原病患者或接受具有白细胞减少潜在风险药物治疗的患者中发生时，会更加严重和频繁。我们的病例报告了一名心力衰竭患者在没有这些加重因素的情况下继发于卡托普利的粒细胞缺乏症。卡托普利继发粒细胞缺乏症的机制目前仍有争议，但在本病例中似乎与剂量无关。因此，卡托普利的处方必须遵循某些规则；肾功能不全时减少剂量，胶原病患者采取常规预防措施。应避免与具有白细胞减少潜在风险的药物联用。血液学监测将根据每个具体病例进行调整。
