Rosuvastatin-Induced Thrombocytopenic Purpura-A Case Report

引起血小板減少性紫斑症的藥物種類繁多，其中包括了降血脂藥。Rosuvastatin為一透過抑制3-hydroxy-3-methylglutaryl-CoA還原的降血脂藥，過去並無文獻報告rosuvastatin引起血小板減少性紫斑症，在此我們提出第一個病例報告。本文報告一位57歲男性，每日服用20毫克rosuvastatin的一個月後，身上出現廣泛性的瘀點與紫斑。當病人停掉此藥且使用為期4週的口服類固醇methylprednisolone後，紫斑完全消失。此紫斑可能由免疫反應所引起。此外，因為statin類的降血脂藥物可以經由抑制活化的血小板血栓PAR-1受體，而具備抗血小板與抗血栓的特性，所以我們推測rosuvastatin可能透過大量抑制血小板血栓受體而產生血小板減少性紫斑症。目前rosuvastatin廣泛地被用來治療高血脂症，而藥物動力學研究結果發現與白種人相較，亞洲人rosuvastatin的血中濃度為其2倍，因此臨床醫師應特別注意亞洲人的起始劑量且需熟悉藥物的副作用。

關鍵字

無資料

並列摘要

Many medications can cause thrombocytopenic purpura, including some hypolipidemic agents. This is the first case report of thrombocytopenic purpura due to the 3-hydroxy-3-meth-ylglutaryl-coenzyme A reductase inhibitor, rosuvastatin. A 57-year-old Asian man developed multiple petechiae and purpura one month after receiving rosuvastatin in a dosage of 20 mg/day. When the drug was stopped and the patient was treated with systemic methylprednisolone, 24 mg/day, his symptoms cleared within 4 weeks. The symptoms may have been due to an immune-mediated reaction. Also, since statins can alter antiplatelet and antithrombotic properties through significant inhibition of the activated platelet thrombin receptor (Proteinase-Activated Receptor-1), an overwhelming inhibition of platelet thrombin receptors might also have caused the thrombocytopenia. Because rosuvastatin is used throughout the world to treat hyperlipidemia, and Asian patients have a twofold higher systemic exposure than do Caucasian patients, physicians should be familiar with its possible adverse effects, and use with caution when determining the starting dose, especially among Asian patients.

並列關鍵字

Rosuvastatin ； Idiopathic thrombocytopenic purpura ； Thrombotic thrombocytopenic purpura ； Low-density lipoprotein ； High-density lipoprotein

國際替代計量

Rosuvastatin-Induced Thrombocytopenic Purpura-A Case Report

全文下載

主題瀏覽