クロラムフェニコール, チアムフェニコール及びペニシリンによる老年者急性骨髄機能不全に関する血液学的検討, とくに末梢血液像および肝機能について

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  • Hematological Studies on Acute Bone Marrow Failure due to Chloramphenicol, Thiamphenicol and Penicillin in the Aged, with Special Reference to Peripheral Blood Figures and Liver Function
  • クロラムフェニコール チアムフェニコール オヨビ ペニシリン ニヨル ロウネン

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The purpose of this paper is to clarify hematological characteristics on peripheral blood figure and pathogenetic significance of liver dysfunction in the aged subjected to drug-induced acute bone marrow failure.<br>Several points concerning the administration of drugs, as well as the changes of blood figures were investigated in 17 cases of the aged with acute bone marrow failure due to chloramphenicol (CP), thiamphenicol (TP), aminobenzylpenicillin (AB-Pc) and carbenicillin (CB-Pc). Furthermore, both renal and liver fuction prior to the occurrence of bone marrow failure were retrospectively investigated in these patients.<br>The results obtained were as follows:<br>1. These patients consisted of 13 cases of CP and/or TP, 3 cases of AB-Pc and a case of CB-Pc. Injury of erythroid cells was most frequently observed (15 cases among 17 patients), and secondly injury of thrombocytes was observed (10 cases among 17 patients). Abnormalities of blood figures were mostly found out 7 to 15 days in CP and/or TP cases and 4 to 5 dyas in AB-, CB-Pc cases after the institution of drug administration. Discontinuance of drugs was immediately (mostly within 7 days) followed by rapid recovery of the injuried blood cells in all but three cases died directly or indirectly due to the drugs.<br>2. Comparative studies on both renal and liver functions between the group associated with acute bone marrow failure and the other group not associated with acute bone marrow failure after CP and/or TP administration were carried out in 646 patients received CP and/or TP administration. Abnormalities of GPT were significantly more frequently observed in the former group than in the latter group.<br>3. Simultaneous injuries of liver and bone marrow were observed in two TP cases and a AB-Pc case. However, such an acute bone marrow failure seemed to occur independently of liver injury. Both injuries were thought to be induced separately but simultaneously by drugs.<br>In conclusion, various antibiotics including CP and TP are likely to induce acute bone marrow failure more frequently in the aged than in the other population. Abnormal elevation of GPT is postulated to play a role in an occurrence of drug-induced acute bone marrow failure.

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