瑞戈非尼致重度血小板减少一例

Analysis of severe thrombocytopenia caused by regorafenib:a case report

本文报道1例85岁男性患者,心房颤动20余年,肝癌13年,3年前规律使用利伐沙班,血小板计数(PLT)轻度减少(最低均值>100×10^(9)/L),1个月前肝脏MRI提示肝癌进展,更换为瑞戈非尼治疗22 d后PLT降至29×10^(9)/L,临床药师会诊后考虑为瑞戈非尼致重度PLT减少,同时不排除利伐沙班加剧PLT减少的可能,停用瑞戈非尼及利伐沙班,并给予对症处理后,PLT逐渐升高至60×10^(9)/L,患者病情稳定出院。

This article reported a case of an 85-year-old male patient with atrial fibrillation for over 20 years and liver cancer for 13 years.He had regularly taken rivaroxaban for 3 years with mild thrombocytopenia(platelet count over minimum mean 100×10^(9)/L).One month ago,liver magnetic resonance imaging of this patient indicated the progress of liver cancer.Af⁃ter switching to regorafenib therapy for 22 days,his platelet count decreased to 29×10^(9)/L.After consultation with clinical phar⁃macists,it was considered as severe thrombocytopenia induced by regorafenib,and the possibility of rivaroxaban exacerbating thrombocytopenia cannot be ruled out.Therefore,regorafenib and rivaroxaban were discontinued,and symptomatic treatment was given,the platelet count of the patient gradually increased to 60×10^(9)/L,and the patient was discharged in stable condition.