Agranulocytosis associated with carbamazepine combined with nimesulide
10.3760/cma.j.issn.1008-5734.2014.05.020
- VernacularTitle:卡马西平联用尼美舒利相关粒细胞缺乏症
- Author:
Ming ZHANG
1
;
Liwen XU
1
;
Xijun GU
1
Author Information
1. 200032上海中医药大学附属龙华医院药剂科
- Publication Type:Journal Article
- Keywords:
Agranulocytosis;
Leukopenia;
Carbamazepine
- From:
Adverse Drug Reactions Journal
2014;(5):311-312
- CountryChina
- Language:Chinese
-
Abstract:
A 78-year-old man received intravenous infusion of ceftizoxime sodium 2. 25 g once daily,oral carbamazepine 0. 2 g twice daily,oral nimesulide 100 mg twice daily,intravenous infusion of dihydroxypropyl theophylline 0. 5 g once daily,oral mecobalamin 0. 5 mg thrice daily,intravenous infusion of dexamethasone 5 mg for one time,intramuscular injection of meperidine hydrochloride 25 mg for one time, and intramuscular injection of bucinnazine hydrochloride 100 mg for three times for postherpetic neuralgia and chronic obstructive pulmonary diseases with infection. On day 7,ceftizoxime sodium was stopped and changed to intravenous infusion of fosfomycin sodium 8 g once daily. On day 11, his blood routine examination showed the following levels:white blood cell count 1. 6 × 109/L with neutrophils 0. 03,neutrophil absolute count 0. 1 × 109/L,and lymphocyte absolute count 0. 9 × 109/L. All the drugs were discontinued and symptomatic and supportive treatment was given. On day 15,the level of white blood cell became 0. 9 × 109/L with neutrophils 0. 02,a absolute value of neutrophil and lymphocyte were respectively 0. 1 × 109/L and 0. 7 × 109/L. According to bone marrow smear histology,agranulocytosis was diagnosed. On day 17, the patient developed pneumothorax and atelectasis in the right lung. On day 20,acute respiratory failure and multiple organ failure occurred with infection and the resuscitation was unsuccessful.
