Acute hemolytic reaction in patients with novel coronavirus pneumonia induced by high-dose ribavirin injection: report of 2 cases
10.3760/cma.j.cn114015-20200412-00518
- VernacularTitle:大剂量利巴韦林注射液致新型冠状病毒肺炎患者急性溶血反应2例
- Author:
Jian GAO
1
;
Weichao QIAO
;
Qing XIA
;
Qing ZHANG
Author Information
1. 河北省承德市第三医院感染科 067000
- Publication Type:Journal Article
- Keywords:
Anemia, hemolytic;
Ribavirin;
Coronavirus infections
- From:
Adverse Drug Reactions Journal
2020;22(9):547-549
- CountryChina
- Language:Chinese
-
Abstract:
Two female patients (patient 1, 22-year-old; patient 2, 50-year-old) received IV infusion of ribavirin injection (4 g in the first dose and the next day 1.2 g thrice daily), oral 2 lopinavir and ritonavir tablets twice daily, and aerosol inhalation of recombinant human interferon α2b for injection for novel coronavirus pneumonia. There was no obvious abnormality in blood routine and liver function before treatment. Laboratory tests showed red blood cell count (RBC) 2.89×10 12/L, hemoglobin (Hb) 75 g/L, alanine aminotransferase (ALT) 22.8 U/L, aspartate aminotransferase (AST) 33.9 U/L, total bilirubin (TBil) 71.2 μmol/L, and indirect bilirubin (IBil) 63.5 μmol/L in patient 1 on the 2nd day of treatment, and RBC 3.46×10 12/L, Hb 95 g/L, ALT 17.7 U/L, AST 21.3 U/L, TBil 86.1 μmol/L, and IBil 67.1 μmol/L in patient 2 on the 3rd day of treatment. The direct antiglobulin test was positive, indirect antiglobulin test was negative, and antinuclear antibody test was negative in both patients. They were diagnosed as having acute hemolytic anemia. Con-sidering the relationship to ribavirin, ribavirin was given in reduced dose and then finally discontinued in patient 1, and was discontinued directly in patient 2. On the basis of continued use of the other 2 drugs, both of them were treated with ursodeoxycholic acid. The Hb and bilirubin level of the 2 patients gradually returned to normal.
