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Agranulocytosis Induced by Sinomenine Hydrochloride
Juerong Chen1, Bing Zhong1, Yong Wang1
1Department of Rheumatology, Southwest Hospital, Third Military Medical University, Chongqing, China (mainland).
The American Journal of Case Reports
|September 7, 2017
Summary
Sinomenine hydrochloride, used for rheumatic diseases, can cause agranulocytosis, a severe drop in neutrophils. Monitoring blood counts is crucial during treatment with this herbal medicine.
Area of Science:
- Pharmacology
- Hematology
- Rheumatology
Background:
- Sinomenine hydrochloride is an alkaloid derived from Sinomenium acutum, utilized in traditional Chinese medicine for rheumatic conditions.
- Systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) are autoimmune diseases often managed with various therapeutic agents.
Observation:
- A 44-year-old female patient with SLE and SSc developed agranulocytosis (neutrophil count 0.01×10^9/L) during sinomenine hydrochloride treatment.
- The patient experienced a subsequent opportunistic bacterial infection, indicative of severe immune compromise.
- Bone marrow aspiration revealed a marked decrease in mature granulocytes, consistent with drug-induced toxicity.
Findings:
- Discontinuation of sinomenine hydrochloride therapy led to the recovery of normal granulocyte levels within ten days.
- Treatment with granulocyte colony-stimulating factor (G-CSF) and antibiotics supported the patient's recovery from agranulocytosis and infection.
Implications:
- This case highlights the potential for sinomenine hydrochloride to induce agranulocytosis, a serious adverse effect.
- Routine monitoring of bone marrow function and neutrophil counts is recommended for patients undergoing treatment with sinomenine hydrochloride.
- Awareness of this risk is essential for clinicians managing patients with rheumatic diseases, particularly those using herbal medications.
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