摘要
Abstract
AIM To discuss the clinical characteristics,mechanism and treatment of thrombocytopenia caused by tumor necrosis factor-α inhibitor(TNFi),providing reference for the safe and rational use of drugs in clinical practice.METHODS A search and analysis of published case reports of TNFi-induced thrombocytopenia in commonly used Chinese and English databases were performed to collect information on age,sex,primary disease,underlying disease,medication use,occurrence time and manifestation of adverse reactions,treatment regimens,clinical outcome,and possible mechanisms of adverse events.The descriptive method was used for analysis.RESULTS A total of 34 pieces of literature on TNFi-induced thrombocytopenia were included,with 40 effective cases,including 17 females(42.5％),18 males(45.0％),and 5 cases without gender information.There were 5 types of TNFi involved,including infliximab in 16 cases(40.0％),adalimumab in 13 cases(32.5％),etanercept in 9 cases(22.5％),golimumab in 1 case(2.5％)and certolizumab pegol in 1 case(2.5％).Regarding laboratory examination,the minimum platelet count in 40 cases was 1.0×109·L-1.For TNFi-induced thrombocytopenia,34 cases were treated with discontinuation or symptomatic management,including plasma exchange,glucocorticoids and immunoglobulin.Regarding clinical outcome,20 cases were improved after treatment,and the time for platelet count to return to the normal range varied from 6 days to 32 weeks.CONCLUSION Thrombocytopenia is a rare adverse drug reaction caused by TNFi,which may lead to serious consequences if not managed properly,even endangering the patient's life.Attention should be paid to this issue in clinical practice.关键词
肿瘤坏死因子-α抑制剂/血小板减少/药物不良反应Key words
tumor necrosis factor-α inhibitors/thrombocytopenia/adversedrug reactions
