PDF(Pubmed)
Abstract：
Phenytoin is a commonly prescribed antiepileptic medication for the prevention and treatment of tonic-clonic or partial seizures. Thrombocytopenia is a rare and serious adverse effect of phenytoin. This case report presents the case of a patient with severe thrombocytopenia induced by phenytoin for the treatment of tonic-clonic seizures. A 63-year-old male received 300 mg/day of phenytoin for the treatment of tonic-clonic seizures. Seven days after receiving the first dose of phenytoin, he was diagnosed with severe thrombocytopenia (platelet count 44 x 109/L) without hemorrhage. Phenytoin was discontinued, and seizures were controlled with levetiracetam. Seven days after stopping phenytoin, his daily platelet count improved from 44 to 177 x 109/L. The Naranjo algorithm score of 7 was at a probable level for phenytoin-induced thrombocytopenia. Thrombocytopenia is a serious adverse drug reaction that can result in life-threatening bleeding. Phenytoin-induced thrombocytopenia commonly begins 1-90 days after administration, and the recovery time is 3-21 days. The potential mechanism of phenytoin-induced thrombocytopenia is drug-induced immune thrombocytopenia. Drugs that enhance the concentration of phenytoin epoxide may be a contributing factor in phenytoin-induced thrombocytopenia. Phenytoin-induced thrombocytopenia is a rare but serious hematological complication. It should be recognized early, particularly in patients with a high risk of hemorrhage or concurrently with medications that increase phenytoin epoxide. Regularly consecutive complete blood count tests may be essential in order to detect an early decrease in platelet count in these patients.
摘要：
苯妥英是一种常用的抗癫痫药物，用于预防和治疗强直阵挛性或部分性癫痫发作。血小板减少症是苯妥英钠的一种罕见且严重的不良反应。本病例报告介绍了一例由苯妥英钠引起的严重血小板减少症患者，用于治疗强直阵挛性癫痫发作。一名63岁的男性接受300毫克/天的苯妥英治疗强直阵挛性癫痫发作。在接受第一剂苯妥英后七天，患者被诊断为重度血小板减少症(血小板计数44×109/L),无出血.苯妥英已停产,癫痫发作用左乙拉西坦控制。停用苯妥英七天后,他的每日血小板计数从44提高到177x109/L。Naranjo算法得分为7分可能是苯妥英钠诱导的血小板减少症的水平。血小板减少是一种严重的药物不良反应，可导致危及生命的出血。苯妥英诱导的血小板减少症通常在给药后1-90天开始，恢复时间为3-21天。苯妥英钠诱导的血小板减少症的潜在机制是药物诱导的免疫性血小板减少症。增加苯妥英环氧化物浓度的药物可能是苯妥英诱导的血小板减少症的一个促成因素。苯妥英钠引起的血小板减少症是一种罕见但严重的血液学并发症。应该及早认识到，特别是在出血风险高的患者或同时使用增加苯妥英环氧化物的药物的患者中。定期连续的全血细胞计数测试可能是必要的，以检测这些患者的血小板计数的早期减少。
