注射用艾司奥美拉唑钠致中性粒细胞减少伴发热

Neutropenia and fever induced by esomeprazole sodium for injection

1例58岁女性患者反酸、烧心伴恶心、呕吐,静脉滴注注射用艾司奥美拉唑钠40 mg、1次/d.用药前WBC 4.5×109/L,中性粒细胞计数（NEUT）2.8×109/L.用药第2天WBC 3.4×109/L,NEUT 1.7×109/L;第7天WBC 2.1×109/L,NEUT 0.1×109/L;第10天WBC 1.6 ×109/L,NEUT 0×109/L,并出现畏寒、发热（38.4 ℃）.第11天体温最高达40 ℃,伴咽喉部不适,考虑为艾司奥美拉唑钠所致中性粒细胞减少合并上呼吸道感染,当日停用该药,给予美罗培南抗感染,重组人粒细胞刺激因子升中性粒细胞.停用艾司奥美拉唑钠第3天,患者体温降至36.4 ℃;第4天,WBC 2.3×109/L,NEUT 0.8×109/L;第10天,WBC 8.0 ×109/L,NEUT 4.9×109/L.

A 58-year-old female patient with sour regurgitation, pyrosis, nausea, and vomiting received an IV infusion of esomeprazole sodium for injection 40 mg once daily.Before treatment, her white blood cell （WBC） count was 4.5×109/L and neutrophil （NEUT） count was 2.8×109/L.On day 2 of medication, her WBC was 3.4 ×109/L and NEUT 1.7×109/L.On day 7, the patient′s WBC was 2.1×109/L and NEUT 0.1×109/L.On day 10, her WBC was 1.6 ×109/L and NEUT 0×109/L, she developed chillness and fever （38.4 ℃）.On day 11, her temperature reached 40 ℃ with throat discomfort.She was diagnosed with neutropenia combined with upper respiratory infection due to esomeprazole sodium for injection.Esomeprazole sodium for injection was stopped and meropenem for anti-infection and recombinant human granulocyte colony-stimulating factor for increasing neutrophil were given at the same day.On day 3 of drug withdrawal, her temperature descended to 36.4 ℃.On day 4, her WBC was 2.3×109/L and NEUT 0.8×109/L.On day 10, her WBC increased to 8.0 ×109/L and NEUT 4.9×109/L.