PDF(Pubmed)
Abstract：
Hydroxychloroquine (HCQ) is an immunomodulator used in dermatology and rheumatology. Side effects may be observed on routine monitoring studies before they become clinically apparent. The goal of this retrospective chart review was to assess laboratory abnormalities in dermatologic and rheumatologic patients taking HCQ. Medical records of patients prescribed HCQ were retrospectively reviewed. Demographics, reported side effects, and parameters on baseline and follow-up complete blood count (CBC) and comprehensive metabolic panel (CMP) were recorded and graded. Laboratory abnormalities were considered severe if they were grade 3 or greater according to Common Terminology Criteria for Adverse Events v3.0 and persistent if they continued beyond subsequent laboratory testing. Of 646 eligible charts, 289 had monitoring studies for review. There were 35 severe (grade 3 or 4, 35/289; 12%) adverse events that developed, as noted on CBC or CMP. Of these 35 severe adverse events, 25 self-corrected on subsequent testing, and 10 (10/289, 3%) across 9 patients were persistent, including glomerular filtration rate, alanine transferase, alkaline phosphatase, glucose, hemoglobin and lymphopenia abnormalities. Of these 10 abnormalities, 7/10 (70%) were unlikely due to hydroxychloroquine use according to the calculated Naranjo score for each patient. Severe laboratory abnormalities while taking hydroxychloroquine are rare, even in a population with a high rate of comorbidities. Among the abnormalities observed, the majority of them (70%) were likely due to disease progression or a medication other than hydroxychloroquine. CBC and CMP monitoring for the reason of observing abnormalities while on HCQ should be at the discretion of the prescribing physician.
摘要：
羟氯喹（HCQ）是皮肤病学和风湿病学中使用的免疫调节剂。在临床上变得明显之前，可以在常规监测研究中观察到副作用。这项回顾性图表审查的目的是评估服用HCQ的皮肤病和风湿病患者的实验室异常。采用HCQ处方的患者病历进行回顾性分析。人口统计,报告的副作用，记录基线和随访全血计数(CBC)和综合代谢组(CMP)参数并进行分级.根据不良事件通用术语标准v3.0，如果实验室异常为3级或更高，则认为是严重的，如果它们持续超过随后的实验室测试，则认为是持续的。在646张合格的图表中，289项进行了监测研究以供审查。有35例严重（3级或4级，35/289;12％）发生的不良事件，如CBC或CMP所述。在这35起严重不良事件中，25在后续测试中自我校正，9例患者中有10例(10/289，3%)是持续性的，包括肾小球滤过率，丙氨酸转移酶，碱性磷酸酶,葡萄糖，血红蛋白和淋巴细胞减少异常。在这10个异常中，根据每位患者计算的Naranjo评分，由于使用羟氯喹，因此不太可能为7/10（70％）。在服用羟氯喹时出现严重的实验室异常是罕见的，即使在合并症发生率很高的人群中。在观察到的异常中，其中大多数(70%)可能是由于疾病进展或羟氯喹以外的药物治疗.CBC和CMP监测的原因是在HCQ时观察到异常，应由处方医师自行决定。
