双氯芬酸钠致免疫性血小板减少  

Immune thrombocytopenia induced by diclofenac sodium

作　　者：刘娇 张熊坚 刘英雄[1] Liu Jiao;Zhang Xiongjian;Liu Yingxiong(Department of Medical Oncology/Hematology,Changshan County People′s Hospital of Zhejiang Province,Quzhou 324299,China;Department of Otolaryngology,Changshan County People′s Hospital of Zhejiang Province,Quzhou 324299,China)

机构地区：[1]浙江省常山县人民医院肿瘤内科/血液科病区,衢州324299 [2]浙江省常山县人民医院耳鼻喉科,衢州324299

出　　处：《药物不良反应杂志》2024年第11期700-702,共3页Adverse Drug Reactions Journal

摘　　要：1例66岁男性患者因关节痛自行服用双氯芬酸钠(0.1 g、1次/d),用药3 d后出现口腔出血,血小板计数(PLT)1×10^(9)/L。因患者既往PLT正常,仅短期应用双氯芬酸钠,经骨髓穿刺及骨髓活检等检查,诊断为免疫性血小板减少症。停用双氯芬酸钠,给予糖皮质激素、输注血小板、止血等,治疗第7天PLT升至164×10^(9)/L。其后多次复查PLT均正常。约2个月后患者再次因关节痛服用双氯芬酸钠,用药2 d后PLT 8×10^(9)/L。停用双氯芬酸钠,并在前次治疗方案基础上加用重组人血小板生成素和利可君片,治疗4 d后PLT升至117×10^(9)/L。考虑患者PLT减少为双氯芬酸钠所致。A 66‑year‑old male patient administered diclofenac sodium 10 mg once daily for arthralgia by himself.After 3 days of medication,he developed oral bleeding and a platelet count(PLT)of 1×10^(9)/L.Considering that the patient had normal PLT previously and diclofenac sodium was used only for a short time,he was diagnosed with immune thrombocytopenia after a series of examinations including bone marrow aspiration and biopsy.Diclofenac sodium was discontinued,and the patient was treated with glucocorticoids,platelet transfusion,and hemostasis therapy.On the 7th day of treatments,the PLT increased to 164×10^(9)/L,and subsequent PLT re‑examinations remained normal.Approximately 2 months later,the patient took diclofenac sodium for arthralgia again.After 2 days of medication,the PLT dropped to 8×10^(9)/L.Diclofenac sodium was discontinued,and the patient was treated with the previous therapeutic regimen,supplemented with recombinant human thrombopoietin and leucogen tablets.After 4 days of treatments,the PLT increased to 117×10^(9)/L.The patient′s reduction in PLT was considered to be caused by diclofenac sodium.

关 键 词：血小板减少 氯芬酸 消炎药 非甾类 药源性免疫性血小板减少症 

分 类 号：R969[医药卫生—药理学]