Dorr V J, Cook J
Division of Hematology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, USA.
South Med J. 1996 Jun;89(6):612-4. doi: 10.1097/00007611-199606000-00011.
The use of "unconventional" or alternative medicine has been reported in up to one third of American households, yet only 28% report the use of such agents to their physician. We present here a case of near fatal sepsis and agranulocytosis. The agranulocytosis is attributed to the use of dipyrone (Dolo-Tiaminol), which the patient obtained in Mexico as a stronger form of generic "aspirin." The pyrazolone class of analgesics, of which dipyrone is a derivative, was introduced in the late 19th century and had a meteoric rise in use until an associated rise in fatal agranulocytosis was discovered. These agents were banned by the Food and Drug Administration (FDA) in 1977. Dipyrone is thought to induce agranulocytosis by inducing an antibody response. With the widespread use of alternative treatments, it is important for physicians to inquire as to the use of unprescribed drugs. Several resources are available to aid with the identification of foreign drugs.
据报道，多达三分之一的美国家庭使用过“非传统”或替代药物，但只有28%的人向医生报告使用过这类药物。我们在此报告一例近乎致命的败血症和粒细胞缺乏症病例。粒细胞缺乏症归因于使用了双氯芬酸（多洛-硫胺醇），患者在墨西哥获得这种药物，它是一种更强效的通用“阿司匹林”。双氯芬酸属于吡唑酮类镇痛药，该类药物在19世纪末被引入，其使用量迅速上升，直到发现与之相关的致命性粒细胞缺乏症病例增加。这些药物于1977年被美国食品药品监督管理局（FDA）禁用。双氯芬酸被认为是通过诱导抗体反应来引发粒细胞缺乏症。随着替代疗法的广泛使用，医生询问患者是否使用过非处方药非常重要。有多种资源可帮助识别外国药物。
