Zhang RY, Zhang JJ, Li JM, Xu YY, Xu YH, Cai XJ. Latamoxef-induced severe thrombocytopenia during the treatment of pulmonary infection: A case report. World J Clin Cases 2022; 10(22): 7906-7912 [PMID: 36158491 DOI: 10.12998/wjcc.v10.i22.7906]
Corresponding Author of This Article
Xin-Jun Cai, Doctor, Chief Pharmacist, Department of Pharmacy, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Xiacheng District, Hangzhou 310000, Zhejiang Province, China. zjtcmcxj@zcmu.edu.cn
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ruo-Ying Zhang, Jin-Meng Li, Ying-Ying Xu, Xin-Jun Cai, Department of Pharmacy, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Jun-Jie Zhang, Department of Out-patient, Zhejiang Medical and Health Group Hangzhou Hospital, Hangzhou 310000, Zhejiang Province, China
Yue-Huan Xu, Tuberculosis Treatment Centre, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Author contributions: Zhang RY proposed and supervised the study; Zhang JJ assisted with data analysis, Li JM, Xu YY and Xu YH managed the patient and collected samples; Cai XJ evaluated data and modified the manuscript; all authors contributed to the design and interpretation of the study and to further drafts.
Supported bythe Special Research Fund of Hospital Pharmacy of Zhejiang Pharmaceutical Society, No. 2019ZYY27; and Zhejiang Medical and Health Science and Technology Plan, No. 2020KY741 and No. 2021KY910.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Jun Cai, Doctor, Chief Pharmacist, Department of Pharmacy, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Xiacheng District, Hangzhou 310000, Zhejiang Province, China. zjtcmcxj@zcmu.edu.cn
Received: October 13, 2021 Peer-review started: October 13, 2021 First decision: January 11, 2022 Revised: January 24, 2022 Accepted: June 24, 2022 Article in press: June 24, 2022 Published online: August 6, 2022 Processing time: 281 Days and 19.7 Hours
Abstract
BACKGROUND
Latamoxef shows excellent antibacterial activity against anaerobic bacteria such as Bacteroides fragilis. Reports of thrombocytopenic toxicity of latamoxef are limited. This report presents a case of severe thrombocytopenia possibly induced by latamoxef, an infrequent adverse drug reaction in a young patient with tuberculosis and Crohn's disease in China.
CASE SUMMARY
We reported a case of severe thrombocytopenia induced by latamoxef in a 28-year-old man with tuberculosis and Crohn's disease. On admission, the patient presented with a cough productive of bloody sputum, a chest computed tomogram suggested scattered mottled, high-density shadows in both lungs. Laboratory tests indicated a platelet count of 140000/μL. Considered a pulmonary bacterial infection, the patient received anti-infection therapy with latamoxef (dose: 2.0 g) intravenously Q12h. On the 9th day of treatment, the platelet count decreased to 44000/μL. On the 12th day, scattered purpura and ecchymosis appeared on the patient’s limbs and trunk, and the platelet count decreased to 9000/μL after latamoxef treatment for 15 d. Three days after discontinuation of latamoxef, the platelet count recovered to 157000/μL, and the area of scattered purpura and ecchymosis on the limbs and trunk decreased. The platelet counts remained in the normal range, and no thrombocytopenia was found at follow-up 15 mo after discharge.
CONCLUSION
For patients treated with latamoxef, platelet counts should be carefully followed, and caregivers should be vigilant for the appearance of scattered ecchymosis.
Core Tip: We described a case of severe thrombocytopenia likely induced by latamoxef, an infrequent adverse drug reaction in a young patient with tuberculosis and Crohn's disease. We followed the changes in platelet counts and the appearance of purpura during latamoxef treatment and after drug withdrawal and excluded other possible causes of thrombocytopenia. Our findings suggested that the patient's thrombocytopenia was caused by latamoxef. This is the first reported case of severe thrombocytopenia induced by latamoxef in a young Chinese patient to the best of our knowledge.
