Arbiser J L, Goldstein A M, Gordon D
Department of Medicine, Beth Israel Hospital, Boston, Massachusetts.
J Intern Med. 1993 Jul;234(1):91-4. doi: 10.1111/j.1365-2796.1993.tb00710.x.
Cimetidine and phenytoin are useful medications often used together in patients with seizure disorders secondary to brain masses or metabolic abnormalities. We describe a case of thrombocytopenia in the setting of concurrent phenytoin, dexamethasone and cimetidine administration, and compare it with previously described cases of thrombocytopenia induced by concurrent use of phenytoin, cimetidine, and glucocorticoids. The similarities between these cases suggest mechanisms by which these agents may induce thrombocytopenia, specifically through potential downregulation of epoxide hydrolase by glucocorticoids.
西咪替丁和苯妥英钠是常用药物，常用于患有继发于脑肿瘤或代谢异常的癫痫症患者。我们描述了一例在同时使用苯妥英钠、地塞米松和西咪替丁的情况下发生血小板减少症的病例，并将其与先前描述的因同时使用苯妥英钠、西咪替丁和糖皮质激素而诱发血小板减少症的病例进行比较。这些病例之间的相似之处提示了这些药物可能诱发血小板减少症的机制，特别是糖皮质激素可能通过潜在下调环氧水解酶来实现。
