- 期刊
Cyclosporin in the Treatment of Severe Aplastic Anemia: Report of One Case
以環孢靈治療嚴重再生不良性貧血：一病例報告
摘要
近年來，國外文獻報告許多能以環孢靈治療嚴重再生不良性貧血成功的病例，其使用是基於目前實驗及臨床上的證據顯示再生不良性貧血可能與免疫媒介轉機有關。本文報告－14歲患嚴重再生不良性貧血男孩，經6個月使用類固醇製劑治療無效後，於民國75年6月在省立桃園醫院除類固醇製劑外，開始接受環孢靈治療，獲得改善的經驗。病人在使用環孢靈三週後即不用再輸任何血成分，第28天後加上服Danazol，經過治療105天後，臨床症狀消失，週邊血液檢查恢復正常，在使用環孢靈375天後，骨髓檢查正常。治療期間，雖然有多毛症狀，高血壓及牙齦肥等副作用，但在劑量逐漸減少後，副作用消失。雖然停止服用環孢靈六個月以上，目前病患血液相仍維持正常。本文證實：環孢靈加上類固醇及Danazol治療嚴重再生不良性貧血有效，且未發現有嚴重之副作用。由於它是一個罕見成功案例，所以我們提出經驗與討論。
關鍵字
無資料並列摘要
According to recent reports, cyclosporine (CsA) has been proven to be a cure for some patients with severe aplastic anemia (SAA). The use of CsA to treat SAA is based on both experimental and clinical evidences showing that this disease is sometimes caused by immune-mediated mechanisms. This report describes a fourteen-year-old boy who recovered from SAA after being treated with CsA, together with to a lesser extent prednisolone. In June of 1986, when he failed to improve after receiving six months of corticosteroid treatment, CsA was introduced. Following three weeks of CsA therapy no further blood transfusion was needed. Danazol was added on the 28th day of CsA therapy. On the 105th day the blood counts began to improve, and on the 375th day bone marrow aspirate revealed normal hematopoiesis. Along with these improvements, however, some side effects from the CsA treatment were observed. These included: hirsutism, hypertension and gingival hyperplasia, all of which eventually subsided on tapering and finally terminating CsA. For the time being, no side effects have been observed in the six-months period since CsA was stopped and the patient is leading a normal life.