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Linezolid-induced pure red cell aplasia: a case report and literature review
Linezolid (LZD) is the first oxazolidinone with excellent safety and efficacy profiles against refractory infections caused by gram-positive organisms. Hematological toxicities such as thrombocytopenia, anemia, and leukocytopenia are common in LZD therapy; however, LZD-induced pure red cell aplasia...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259366/ https://www.ncbi.nlm.nih.gov/pubmed/30270705 http://dx.doi.org/10.1177/0300060518800126 |
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author | Luo, Zhuanbo Xu, Ning Wang, Yun Huang, Xiaoping Cao, Chao Chen, Lei |
author_facet | Luo, Zhuanbo Xu, Ning Wang, Yun Huang, Xiaoping Cao, Chao Chen, Lei |
author_sort | Luo, Zhuanbo |
collection | PubMed |
description | Linezolid (LZD) is the first oxazolidinone with excellent safety and efficacy profiles against refractory infections caused by gram-positive organisms. Hematological toxicities such as thrombocytopenia, anemia, and leukocytopenia are common in LZD therapy; however, LZD-induced pure red cell aplasia (PRCA) is rare. An 83-year-old man diagnosed with pleural empyema caused by Staphylococcus aureus received LZD after developing resistance to multiple antibiotics. Although his infection-related symptoms were improved by LZD, progressive anemia was noticed after LZD therapy was initiated. Eight weeks after LZD administration began, his hemoglobin level was 5.7 g/dL and reticulocyte proportion was 0.36%, while his white blood cell and platelet counts remained unchanged since admission. Bone marrow examination revealed markedly decreased erythropoiesis with cytoplasmic vacuolation of erythroblasts. Anemia resolved by 14 days after cessation of LZD. It is important to increase the awareness among clinicians about the potential for the hematological effects associated with LZD, particularly for older patients with pre-existing anemia and treatment courses longer than 14 days. To detect bone marrow suppression, including PRCA, we suggest monitoring the complete blood count and reticulocyte count periodically in patients receiving long-term LZD therapy. |
format | Online Article Text |
id | pubmed-6259366 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-62593662018-11-30 Linezolid-induced pure red cell aplasia: a case report and literature review Luo, Zhuanbo Xu, Ning Wang, Yun Huang, Xiaoping Cao, Chao Chen, Lei J Int Med Res Case Reports Linezolid (LZD) is the first oxazolidinone with excellent safety and efficacy profiles against refractory infections caused by gram-positive organisms. Hematological toxicities such as thrombocytopenia, anemia, and leukocytopenia are common in LZD therapy; however, LZD-induced pure red cell aplasia (PRCA) is rare. An 83-year-old man diagnosed with pleural empyema caused by Staphylococcus aureus received LZD after developing resistance to multiple antibiotics. Although his infection-related symptoms were improved by LZD, progressive anemia was noticed after LZD therapy was initiated. Eight weeks after LZD administration began, his hemoglobin level was 5.7 g/dL and reticulocyte proportion was 0.36%, while his white blood cell and platelet counts remained unchanged since admission. Bone marrow examination revealed markedly decreased erythropoiesis with cytoplasmic vacuolation of erythroblasts. Anemia resolved by 14 days after cessation of LZD. It is important to increase the awareness among clinicians about the potential for the hematological effects associated with LZD, particularly for older patients with pre-existing anemia and treatment courses longer than 14 days. To detect bone marrow suppression, including PRCA, we suggest monitoring the complete blood count and reticulocyte count periodically in patients receiving long-term LZD therapy. SAGE Publications 2018-10-01 2018-11 /pmc/articles/PMC6259366/ /pubmed/30270705 http://dx.doi.org/10.1177/0300060518800126 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Reports Luo, Zhuanbo Xu, Ning Wang, Yun Huang, Xiaoping Cao, Chao Chen, Lei Linezolid-induced pure red cell aplasia: a case report and literature review |
title | Linezolid-induced pure red cell aplasia: a case report and literature review |
title_full | Linezolid-induced pure red cell aplasia: a case report and literature review |
title_fullStr | Linezolid-induced pure red cell aplasia: a case report and literature review |
title_full_unstemmed | Linezolid-induced pure red cell aplasia: a case report and literature review |
title_short | Linezolid-induced pure red cell aplasia: a case report and literature review |
title_sort | linezolid-induced pure red cell aplasia: a case report and literature review |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259366/ https://www.ncbi.nlm.nih.gov/pubmed/30270705 http://dx.doi.org/10.1177/0300060518800126 |
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