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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...

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Autores principales: Luo, Zhuanbo, Xu, Ning, Wang, Yun, Huang, Xiaoping, Cao, Chao, Chen, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
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.
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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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