病例报告：多粘菌素E相关的可逆性白细胞减少症。
Case Report: Polymyxin E-associated reversible leukopenia.
作者信息
Wan Suxin, Zhu Jia-Quan, Wang Lihua
机构信息
Department of Pharmacy, Chongqing University Three Gorges Hospital, Chongqing University, Chongqing, China.
Fengdu General Hospital, Pharmaceutical Department, Chongqing, China.
出版信息
Front Immunol. 2025 Aug 14;16:1537972. doi: 10.3389/fimmu.2025.1537972. eCollection 2025.
INTRODUCTION
With the increasing challenge of antibiotic resistance, polymyxin E is considered a last-line treatment option for infections caused by highly resistant bacteria. However, its use may lead to various adverse reactions, such as nephrotoxicity, neurotoxicity, and allergic reactions.
CASE PRESENTATION
This study describes a case of polymyxin E-associated leukopenia in a 50-year-old female treated for infection. During polymyxin E therapy, the patient developed leukopenia, with white blood cell (WBC) counts declining from 5.65×10/L to 0.91×10/L. The condition resolved progressively after the cessation of polymyxin E. The Naranjo scale yielded a score of 7 for polymyxin E-associated leukopenia, while other medications scored ≤0. The WHO-Uppsala Monitoring Centre (WHO-UMC) causality classification system categorized the relationship as 'probable.'
CONCLUSION
These findings suggest that polymyxin E likely induces leukopenia, emphasizing the need for rigorous WBC monitoring during treatment and prompt discontinuation when hematologic abnormalities emerge to minimize patient health risks.
引言
随着抗生素耐药性挑战的不断增加，多粘菌素E被视为治疗高度耐药菌感染的最后一线治疗选择。然而，其使用可能导致各种不良反应，如肾毒性、神经毒性和过敏反应。
病例报告
本研究描述了一例在接受感染治疗的50岁女性中发生的多粘菌素E相关性白细胞减少症。在多粘菌素E治疗期间，患者出现白细胞减少，白细胞（WBC）计数从5.65×10⁹/L降至0.91×10⁹/L。停用多粘菌素E后病情逐渐缓解。对于多粘菌素E相关性白细胞减少症，Naranjo量表评分为7分，而其他药物评分为≤0分。世界卫生组织-乌普萨拉监测中心（WHO-UMC）因果关系分类系统将该关系归类为“很可能”。
结论
这些发现表明多粘菌素E可能诱发白细胞减少，强调在治疗期间需要严格监测白细胞，当出现血液学异常时及时停药，以将患者健康风险降至最低。
Zotero 插件