Pancytopenia induced by overdose of ganciclovir
10.3760/cma.j.cn114015-20201209-01227
- VernacularTitle:超剂量使用更昔洛韦致全血细胞减少
- Author:
Zuojun LI
1
;
Xinliang YANG
;
Yejun CHEN
;
Li WANG
;
Wenjian ZUO
;
Xiaohong LIU
;
Chunjiang WANG
Author Information
1. 中南大学湘雅三医院药学部，长沙 410000
- Publication Type:Journal Article
- Keywords:
Ganciclovir;
Pancytopenia;
Cytomegalovirus infections
- From:
Adverse Drug Reactions Journal
2021;23(8):440-442
- CountryChina
- Language:Chinese
-
Abstract:
A 42-year-old female patient who had a fever for 10 days and was suspected of cytomegalovirus infection received IV infusions of ganciclovir 150 mg dissolved in 0.9% sodium chloride injection 100 ml and cefoperazone sodium and tazobactam sodium 2.25 g dissolved in 0.9% sodium chloride injection 100 ml twice daily. Before medication, the patient′s white blood cell count (WBC) was 12.71×10 9/L, platelet count (PLT) was 262×10 9/L, ren blood cell count (RBC) was 2.99×10 12/L, and hemoglobin (Hb) was 84 g/L. Because the patient developed edema 2 days later, the drugs were adjusted to IV infusions of ganciclovir 150 mg dissolved in 0.9% sodium chloride injection 50 ml once daily and piperacillin sodium tazobactam sodium 2.25 g dissolved in 0.9% sodium chloride injection 50 ml twice daily. On day 11 of medication, laboratory tests showed WBC 3.01×10 9/L, 2.32×10 9/L, PLT 92×10 9/L, RBC 2.39×10 12/L and Hb 68 g/L; on day 13 of medication, her WBC was 1.98×10 9/L, PLT was 86×10 9/L, RBC was 2.44×10 12/L, and Hb was 69 g/L. After tracing the patient′s previous medical records, it was learned that the patient had previously experienced mild myelosuppression due to ganciclovir treatment. Then ganciclovir-induced pancytopenia was considered. Ganciclovir was stopped and subcutaneous injections of recombinant human granulocyte stimulating factor injection 200 μg once daily and recombinant human erythropoietin injection 10 000 U once a week were given. Five days later, laboratory tests showed WBC 3.82×10 9/L, PLT 197×10 9/L, RBC 3.12×10 12/L, and Hb 92 g/L. The patient had renal transplantion 3 years ago. According to the level of creatinine clearance rate, overdose of ganciclovir was used in the patient.
