Blood coagulation disorders caused by cefmenoxime in a patient with renal failure and pancreatitis
Department of Clinical Laboratory, Luannan Hospital, Hebei Province, Luannan 063500, China; Department of Internal Medicine, Luannan Hospital, Hebei Province, Luannan 063500, China
Abstract:A 65-year-old female patient with chronic renal failure undergoing continuous hemo- dialysis received an IV infusion of cefmenoxime 1 g twice daily for acute pancreatitis. The values of prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) were within the normal range before treatment. After 11 days of treatment, the patient developed multiple ecchymoses on the skin and bleeding from the venipuncture site which was not easily stopped. The reexamination of coagulation function showed PT 127-s, INR 10.72, and APTT 86-s. Coagulation dysfunction was considered and an IV infusion of leukocyte-reduced fresh-frozen plasma 150-ml was given. Examination of coagulation function next day showed PT 101-s, INR 8.49, and APTT 65-s. Mixing study for evaluation of abnormal coagulation testing showed that PT and APTT could be corrected, suggesting coagulation factor deficiency. Blood coagulation disorders caused by cefmenoxime was considered. Then the drug was discontinued and switched to amoxicillin sodium and clavulanate potassium, and a subcutaneous injection of vitamin K1-10-mg was given once daily. Three days after the drug withdrawal, her coagulation function returned to within the normal range (PT 15-s, INR 1.19, APTT 36-s).
杨春生,孟玉玫,姜文勇,王洪娜,梁金山,刘艳梅,阚春娜,朱学良,刘玉,遇建鹏. 头孢甲肟致肾衰竭合并胰腺炎患者凝血功能障碍[J]. 药物不良反应杂志, 2021, 23(5): 279-280.
Yang Chunsheng, Meng Yumei, Jiang Wenyong, Wang Hongna, Liang Jinshan, Liu Yanmei, Kan Chunna, Zhu Xueliang, Liu Yu, Yu Jianpeng. Blood coagulation disorders caused by cefmenoxime in a patient with renal failure and pancreatitis. Adverse Drug Reactions Journal, 2021, 23(5): 279-280.