亚胺培南-西司他丁钠致继发性血小板增多症

Secondary thrombocytosis due to imipenem-cilastatin sodium

1例2岁10个月女性患儿,因咳嗽、发热入院。血常规示WBC 10×109/L,Hb 105 g/L,PLT188×109/L。用头孢呋辛钠等药物治疗5 d疗效不佳。考虑大叶性肺炎,入院第6天血常规示WBC 14×109/L,Hb 97 g/L,PLT254×109/L。给予亚胺培南-西司他丁钠70 mg,1次/8 h。入院第11天血常规示WBC15.7×109/L,Hb 104 g/L,PLT1349×109/L。骨髓象:增生明显活跃,全片可见各型巨核细胞及血小板。入院第13天停用亚胺培南-西司他丁钠。第14天血常规示WBC 6.9×109/L,Hb 104 g/L,PLT226×109/L。

A two years and ten months girl was hospitalized for cough and fever.Routine blood tests revealed the following levels： WBC count 10×109/L,Hb 105g/L,PLT count 188×109/L.The patient was given with cefuroxime sodium for 5 days but the therapy had poor effect.Lobar pneumonia was considered.On day 6 of admission,his routine blood test showed a WBC count of 14×109/L,a Hb level of 97g/L,and a PLT count of 254×109/L.He received imipenem-cilastatin sodium 70 mg every eight hours.On day 11 of admission,routine blood test revealed the following： WBC count 15.7×109/L,Hb 104 g/L,PLT count 1 349×109/L.Bone marrow aspiration showed marked hyperplasia and all kinds of megakaryocytes and platelets covering smear.On day 13,imipenem-cilastatin was discontinued.On day 14,routine blood test revealed a WBC count of 6.9×109/L,a Hb level of 104 g/L,and a PLT count of 226×109/L.