1例泊沙康唑口服混悬液致外周嗜酸性粒细胞增多症分析  

One case of peripheral eosinophilia induced by posaconazole oral suspension

作　　者：钟运鸣 李城 邓映明 熊天增[1] 孟小斌[1] 雷南凤[1] 梁培[3] ZHONG Yunming;Li Cheng;Deng Yingming;XIONG Tianzeng;MENG Xiaobin;Lei Nanfeng;LIANG Pei;无(Meizhou People’s Hospital,Meizhou Guangdong 514000,China;Meizhou Institutes for Food and Drug Control,Meizhou Guangdong 514000,China;Nanjing Drum Tower Hospital,Nanjing Jiangsu 210008,China)

机构地区：[1]梅州市人民医院,广东梅州514000 [2]梅州市食品药品监督检验所,广东梅州514000 [3]南京大学医学院附属鼓楼医院,江苏南京210008

出　　处：《中国药物警戒》2022年第8期921-923,共3页Chinese Journal of Pharmacovigilance

摘　　要：目的探讨泊沙康唑口服混悬液致外周嗜酸性粒细胞增多症的处置措施。方法结合文献检索,分析1例泊沙康唑口服混悬液致外周嗜酸性粒细胞增多症的诊疗经过,探讨泊沙康唑口服混悬液致外周嗜酸性粒细胞增多症的机制和应对措施。结果患者使用泊沙康唑口服混悬液23 d后出现外周嗜酸性粒细胞数增多,伴有头面部红肿、皮疹、瘙痒。立即给予口服氯雷他定片、静脉注射葡萄糖酸钙注射液及地塞米松磷酸钠注射液等对症治疗。对症治疗5 d后患者头面部红肿消退、皮疹、瘙痒逐渐消退,但外周嗜酸性粒细胞数仍逐渐增多,遂停用泊沙康唑口服混悬液。停用泊沙康唑口服混悬液10 d,复查外周嗜酸性粒细胞数逐渐减少。后因病情需要再次使用泊沙康唑口服混悬液,复查外周嗜酸性粒细胞数再次增多,遂在每次服用泊沙康唑混悬液前静脉注射地塞米松磷酸钠注射液,后复查患者外周嗜酸性粒细胞数逐渐恢复正常。结论泊沙康唑口服混悬液致外周嗜酸性粒细胞增多症时应立即停药,或可在服药前静脉注射地塞米松磷酸钠注射液给予预防。Objective To explore treatments against peripheral eosinophilia induced by posaconazole oral suspension.Methods The process of diagnosing and treating one case of peripheral eosinophilia induced by posaconazole oral suspension was analyzed.The mechanism by which posaconazole oral suspension induced peripheral eosinophilia was studied with reference to literature.Results The patient was diagnosed with peripheral eosinophilia 23 days after he took posaconazole oral suspension,accompanied by head and face swelling,rash and pruritus.The drug was suspended immediately.The patient’s condition gradually improved after the treatment with oral loratadine tablets,intravenous calcium gluconate injection and dexamethasone sodium phosphate injection.Head and face swelling subsided,skin rash was significantly mitigated,and itching disappeared within 10 days of withdrawal.Posaconazole suspension was taken a second time because of the patient’s condition.Dexamethasone sodium phosphate injection was injected intravenously before each oral posaconazole suspension before peripheral eosinophils gradually returned to normal.Conclusion The use of posaconazole suspension should be stopped immediately after the occurrence of peripheral eosinophilia,and dexamethasone can be injected intravenously before medication.

关 键 词：泊沙康唑 混悬液 外周嗜酸性粒细胞增多症 药品不良反应 

分 类 号：R994.11[医药卫生—毒理学] R978[医药卫生—药学]