关键词: 抗结核药, 结核,抗多种药物性, 骨髓疾病, 死亡, 综述文献(主题)

Abstract:

Anti-tuberculosis drug is a risk factor for causing bone marrow suppression, which can lead to death in severe cases. This article reported a patient who got bone marrow suppression caused by the use of anti-tuberculosis drugs and died. The authors also did a literature review regarding to this issue. The patient was female, 24 years old. She was found to have bilateral neck masses for more than 1 month and diagnosed as cervical lymph node tuberculosis by puncture biopsy in another hospital before she came to our hospital. After admission, she was confirmed as multidrug-resistant tuberculosis (MDR-TB) by Mycobacterium tuberculosis drug susceptible test (MTB-DST) using the pus obtained from her neck mass. The routine blood examinations were performed for her and the results were normal, and then the initial treatment regimen of anti-tuberculosis (3H-R-Z-E/12H-R) was given to this patient. After she received the treatment, the granulocyte cells were starting to drop slightly and gradually progressed to severe reduction, and then further progressed to severe reductions of the erythroid, granulocyte and megakaryocyte cells. The patient eventually died of infectious shock and failure to resuscitate. By reviewing the relevant publications, the authors did discussions on pathogenesis, clinical manifestations, diagnosis and treatment of bone marrow suppression caused by anti-tuberculosis drugs in this article, aimed to remind clinicians to understand the adverse reactions in blood system caused by anti-tuberculosis drugs and their severity, and to emphasize that the causes of the abnormal blood test results should be identified as soon as possible and the effective intervention measures should be taken soon.

Key words: Antitubercular agents, Tuberculosis, multidrug-resistant, Bone marrow diseases, Death, Review literature as topic