Carlson J A, Maesner J E
Patient Care Services, Group Health Cooperative of Puget Sound, Seattle, WA 98112.
Ann Pharmacother. 1994 Nov;28(11):1236-8. doi: 10.1177/106002809402801103.
To report the first case of ticlopidine-associated neutropenia resulting in sepsis and death.
An 83-year-old Filipino man was started on ticlopidine 250 mg bid. By the seventh week of therapy his absolute neutrophil count (ANC) had dropped to 2700 from 7600 x 10(6) cells/L. The ticlopidine was stopped. Six days later, he was admitted to the hospital. He died 18 hours later of gram-negative sepsis.
Although ticlopidine therapy was discontinued four days after the patient's ANC was 2700 x 10(6) cells/L, the ANC dropped to and remained at 0 until his death eight days later. This may be associated with the patient's decreased clearance of ticlopidine given his age and impaired renal function. This is the first reported case of moderate or severe neutropenia in a nonwhite patient and the first reported case of sepsis and death caused by ticlopidine.
Healthcare professionals must be aware of the possibility of severe neutropenia and death caused by ticlopidine, even when the manufacturers' monitoring guidelines are followed.
报告首例因噻氯匹定相关性中性粒细胞减少症导致败血症及死亡的病例。
一名83岁的菲律宾男性开始服用噻氯匹定，每日两次，每次250毫克。治疗至第七周时，其绝对中性粒细胞计数（ANC）从7600×10⁶/升降至2700。噻氯匹定停药。六天后，他入院治疗。18小时后，因革兰氏阴性菌败血症死亡。
尽管在患者ANC降至2700×10⁶/升四天后停用了噻氯匹定，但ANC继续下降并直至八天后患者死亡时一直维持在0。鉴于患者年龄及肾功能受损，这可能与噻氯匹定清除率降低有关。这是首例在非白人患者中报告的中度或重度中性粒细胞减少症病例，也是首例由噻氯匹定引起败血症及死亡的病例报告。
医疗保健专业人员必须意识到，即使遵循制造商的监测指南，噻氯匹定仍有可能导致严重中性粒细胞减少症及死亡。
