中国药物警戒 ›› 2022, Vol. 19 ›› Issue (3): 345-348.
DOI: 10.19803/j.1672-8629.2022.03.27

• 安全与合理用药 • 上一篇    

甲巯咪唑片致粒细胞缺乏1例分析

朱玉婷1, 李茂星2,*   

  1. 1三二〇一医院药学部,陕西 汉中 723000;
    2解放军联勤保障部队第九四〇医院全军高原环境损伤防治重点实验室,甘肃 兰州 730050
  • 收稿日期:2020-06-10 出版日期:2022-03-15 发布日期:2022-03-16
  • 通讯作者: *李茂星,男,博士,副教授·硕导,高原军事药学。E-mail:limaox2005@aliyun.com
  • 作者简介:朱玉婷,女,硕士,主管药师,临床药学。
  • 基金资助:
    甘肃省卫生行业科研计划项目(GSWSKY2017-25)

One case of agranulocytosis induced by methimazole tablets

ZHU Yuting1, LI Maoxing2,*   

  1. 1Department of Pharmacy, 3201 Hospital, Hanzhong Shaanxi 723000, China;
    2Department of Pharmacy, The 940th Hospital of Joint Logistic Support Force of PLA & Key Laboratory of the Prevention and Cure for the Plateau Environment Damage, PLA, Lanzhou Gansu 730050, China
  • Received:2020-06-10 Online:2022-03-15 Published:2022-03-16

摘要: 目的 探讨甲巯咪唑致粒细胞缺乏(MIA)可能的机制及老年患者的处置措施。方法 通过1例MIA伴感染的老年患者用药,结合文献检索,探索MIA的机制及应对措施。结果 入院后给予抗感染、升白细胞等对症治疗后,患者仍发热;停用抗菌药物并加用甲泼尼龙琥珀酸钠治疗3 d,患者粒细胞逐渐上升;第17日患者血常规基本正常。结论 MIA的机制包括免疫应答、药物毒性、遗传易感性等,建议在诊疗老年患者时制定个体化的给药方案。

关键词: 甲巯咪唑, 粒细胞缺乏, 老年患者

Abstract: Objective To explore the possible mechanism of methimazole-induced agranulocytosis (MIA) and treatments for elderly patients. Methods The process of treating one case of an elderly patient with MIA and infection was analyzed based on literature retrieval. Results Despite anti-infection treatments and increasing the number of white blood cells, the patient remained feverish. Then, the patient's granulocytes gradually increased after antibacterial drugs were discontinued and methylprednisolone sodium succinate was supplemented for 3 days. The blood routine of the patient returned to normal on the 17th day. Conclusion The mechanism of MIA includes immune responses, drug toxicity and genetic susceptibility. It is recommended that an individualized dosing plan be made during the diagnosis and treatment of elderly patients.

Key words: methimazole, agranulocytosis, elderly patient

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