Kim H L, Kovacs M J
University of Western Ontario, London, Canada.
Ann Pharmacother. 1995 Jul-Aug;29(7-8):713-5. doi: 10.1177/106002809502907-813.
To report a case of thrombocytopenia and a case of neutropenia, both associated with the use of diclofenac.
A 63-year-old woman was receiving diclofenac for osteoarthritis. During a hospital admission for pneumonia, she was found to have severe thrombocytopenia. Diclofenac therapy was stopped and the thrombocytopenia resolved. Several months later she was inadvertently treated with diclofenac by another physician and again experienced thrombocytopenia, which again resolved on discontinuation of the drug and has not recurred since. A 72-year-old man was receiving diclofenac for 9 months for osteoarthritis. He was then found to have asymptomatic neutropenia. Diclofenac therapy was stopped and the neutropenia resolved with no other intervention. He was not rechallenged.
Severe thrombocytopenia and neutropenia are extremely rare adverse reactions to diclofenac. To date, there is only 1 case of each that is well documented and supported in the literature.
Severe thrombocytopenia and neutropenia are potential serious adverse effects of the use of diclofenac. Patients who are receiving diclofenac and develop symptoms of either thrombocytopenia or neutropenia should have a complete blood count, and if this diagnosis is confirmed, the drug therapy should be stopped.
报告1例血小板减少症和1例中性粒细胞减少症病例，二者均与双氯芬酸的使用有关。
一名63岁女性因骨关节炎正在接受双氯芬酸治疗。在因肺炎住院期间，发现她患有严重血小板减少症。停用双氯芬酸治疗后，血小板减少症得到缓解。几个月后，另一名医生无意中给她使用了双氯芬酸，她再次出现血小板减少症，在停药后再次缓解，此后未再复发。一名72岁男性因骨关节炎接受双氯芬酸治疗9个月。随后发现他患有无症状中性粒细胞减少症。停用双氯芬酸治疗后，中性粒细胞减少症在未进行其他干预的情况下得到缓解。未对他进行再次用药挑战。
严重血小板减少症和中性粒细胞减少症是双氯芬酸极为罕见的不良反应。迄今为止，文献中每种情况仅有1例记录充分且有依据的病例。
严重血小板减少症和中性粒细胞减少症是使用双氯芬酸可能产生的严重不良反应。正在接受双氯芬酸治疗且出现血小板减少症或中性粒细胞减少症症状的患者应进行全血细胞计数，如果确诊，应停止药物治疗。
