阿维A引起白细胞和血小板增多

Leukocytosis and thrombocytosis induced by acitretin

1例42岁男性患者,因脓疱型银屑病服用阿维A胶囊30mg/d治疗。治疗前血常规基本正常:RBC3.65×1012/L,WBC9.5×109/L,PLT246×109/L。治疗1周后,RBC3.67×1012/L,WBC16.5×109/L,PLT412×109/L。病理学检查示:血小板增多,骨髓增生;B超示脾肿大。将阿维A减量至15mg/d。3周后复查血象:RBC3.72×1012/L,WBC14.3×109/L,PLT446×109/L。阿维A继续减量至10mg/d,2周后复查血象RBC3.48×1012/L,WBC10.3×109/L,PLT385×109/L;腹部B超检查未见异常。

A 42-year-old man with pustular psoriasis was treated with acitretin capsules 30 mg once daily. His routine blood test was basically normal before therapy. He had a RBC count of 3.65 ×10^12/L, a WBC count of 9.5 ×10^9/L, and a PLT count of 246 ×10^9/L. One week after administration, his RBC was 3.67 ×10^12/L, his WBC was 16.5 ×10^9/L, and his PLT was 412 ×10^9/L, respectively. Pathological examination showed thromhocytosis and bone marrow hyperplasia. An ultrasound examination showed splenomegaly. The dosage of acitretin was reduced to 15 mg/day. Three weeks later, a reexamination revealed a RBC count of 3.72 ×10^12/L, a WBC count of 14.3 ×10^9/L, and a PLT count of 446 ×10^9/L. The dosage of acitretin was continuously reduced to 10 mg/day. Two weeks later, a reexamination revealed a RBC count of 3.48 ×10^12/L, a WBC count of 10.3 ×10^9/L, and a PLT count of 385 ×10^9/L. No abnormal abdominal findings were observed on ultrasound examination.