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題 名 | Spironolactone-Induced Agranulocytosis: A Case Report=Spironolactone誘發無顆粒球血症--病例報告 |
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作 者 | 蕭淑華; 林毅志; 許美英; 吳達仁; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 19:11 2003.11[民92.11] |
頁 次 | 頁574-578 |
分類號 | 415.534 |
關鍵詞 | 無顆粒球血症; Spironolactone; Agranulocytosis; |
語 文 | 英文(English) |
中文摘要 | 本文報告一位肝硬化併肝癌病人使用 spironolactone 利尿劑治療腹水後,發生無顆粒球血症(agranulocytosis)不良藥物反應的案例。個案為一 43 歲女姓患者經診斷為肝硬化併肝癌 4 個月,因明顯的腹水問題而住院作治療。住院第 2 天例行血球檢查顯示白血球數目為 3.8 x 109/L。住院第 3 天以 spironolactone 來利尿以改善腹水。住院第 10 天,例行血球檢查顯示明顯白血球數減少(1.8 x 109/L)。4 天後血球檢查顯示白血球數目為 1.8 x 109/L;血球分類顯示無顆粒球血症(中性球 0.25 x 109/L)。Spironolactone 停用 8 天後,白血球數目為 4.9 x 109/L 而中性球數目為 1.76 x 109/L。經檢討臨床狀況、使用藥物與文獻查尋,我們高度懷疑這是一例罕見的 spironolactone 誘發無顆粒球血症的病例。查尋文獻發現 spironolactone 誘發無顆粒球血症被正式報告的有 4 例,然而 4 例均並用 furosemide。本報告應該是 spironolactone 未並用 furosemide,而發生無顆粒球血症之第一個案例。 |
英文摘要 | A 43-year-old woman with liver cirrhosis and hepatocellular carcinoma was admitted for the chief problem of ascites. Laboratory data revealed a leukocyte count of 3.8 x 109/L on the second day of admission. Spironolactone was prescribed for diuresis beginning on the third day. Routine blood tests on the tenth day disclosed marked leukopenia (1.8 x 109/L). Four days later, the leukocyte count was still 1.8 x 109/L and a differential count revealed agranulocytosis (neutrophils, 0.25 x 109/L). Eight days after withdrawal of spironolactone, the leukocyte count returned to normal (leukocytes, 4.9 x 109/L; neutrophils, 1.76 x 109/L). On review of the patient’s clinical condition, concurrent medication, and previous reports, we highly suspected that this episode of agranulocytosis was caused by spironolactone. Unlike four previously reported cases, this one did not involve furosemide, which is reported to be associated with leukopenia and agranulocytosis. |
本系統中英文摘要資訊取自各篇刊載內容。