厄贝沙坦致贫血

Anemia induced by irbesartan

1例47岁男性患者因肾病综合征给予厄贝沙坦225 mg口服、1次/d,3 d后遵医嘱改为300 mg、1次/d。服用厄贝沙坦前患者血红蛋白(Hb)为153 g/L。用药6 d后,患者出现疲乏、无力,实验室检查示Hb 89 g/L,血清肌酐、便常规、骨髓穿刺等检查均未见异常。用药13 d后,Hb为87 g/L。诊断为中度贫血,考虑与厄贝沙坦有关。停用该药,给予注射用甲泼尼龙琥珀酸钠60 mg静脉滴注、1次/d,促红细胞生成素3000 U皮下注射、3次/周。7 d后,患者疲乏、无力症状好转,实验室检查示Hb 102 g/L。27 d后,患者Hb恢复至131 g/L。

A 47‑year‑old male patient received irbesartan 225 mg orally once daily due to nephrotic syndrome.Three days later,the dose was changed to 300 mg once daily according to the doctor′s advice.His hemoglobin(Hb)was 153 g/L before irbesartan treatment.After 6 days of medication,the patient developed fatigue and weakness.Laboratory test showed that his Hb was 89 g/L.No laboratory test abnormality was found in serum creatinine,stool routine,and bone marrow puncture.After 13 days of medication,his Hb was 87 g/L.Moderate anemia related to irbesartan was diagnosed.Irbesartan was discontinued and IV infusion of methylprednisolone sodium succinate for injection 60 mg once daily and subcutaneous injection of erythropoietin 3000 U thrice a week were given.Seven days later,the symptoms of fatigue and weakness were improved and laboratory test showed Hb 102 g/L.Twenty‑seven days later,his Hb returned to 131 g/L.