Thompson D F, Gales M A
Department of Pharmacy Practice, Southwestern Oklahoma State University, Weatherford, USA.
Pharmacotherapy. 1996 Nov-Dec;16(6):1002-8.
Pure red cell aplasia (PRCA) is an uncommon hematologic disorder characterized by the absence of erythroblasts in otherwise normal bone marrow. It is commonly an autoimmune disorder sometimes associated with a congenital error. It may also be acquired in association with thymomas, hematologic malignancies, human parvovirus B19 infection, drugs, and other disease states. Thirty drugs have been implicated as causative in PRCA, but most literature reports describe only one or two patients. Data evaluating possible mechanisms of drug-induced PRCA are extremely limited, with conflicting results from different investigators. The criteria we used were at least five patients reported, reports from at least three separate investigators, and a minimum of one case of probable causality or better using a published assessment scale. With these criteria, phenytoin, azathioprine, and isoniazid had sufficient evidence of causality. All three are documented causes of PRCA and should be considered in any case of selective erythrocyte aplasia.
纯红细胞再生障碍性贫血（PRCA）是一种罕见的血液系统疾病，其特征是在其他方面正常的骨髓中缺乏成红细胞。它通常是一种自身免疫性疾病，有时与先天性缺陷有关。它也可能与胸腺瘤、血液系统恶性肿瘤、人类细小病毒B19感染、药物及其他疾病状态相关。已有30种药物被认为可导致PRCA，但大多数文献报道仅描述了一两名患者。评估药物诱导PRCA可能机制的数据极为有限，不同研究者的结果相互矛盾。我们使用的标准是至少有五例患者报告、至少来自三位独立研究者的报告，以及使用已发表的评估量表至少有一例可能的因果关系或更明确的因果关系。根据这些标准，苯妥英、硫唑嘌呤和异烟肼有充分的因果关系证据。这三种药物均被记录为PRCA的病因，在任何选择性红细胞再生障碍的病例中都应予以考虑。
