Drug-induced thrombotic microangiopathy: a systematic review of published reports
Drug-induced thrombotic microangiopathy: a systematic review of published reports
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DOI：
10.1182/blood-2014-11-611335
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发表时间：
2015-01-22
期刊：
影响因子：
20.3
通讯作者：
George, James N.
中科院分区：
文献类型：
--
作者：
Al-Nouri, Zayd L.;Reese, Jessica A.;George, James N.
许多血栓性微血管病（TMA）综合征的患者，包括血栓性血小板减少性紫癜和溶血性尿毒症综合征，已被报道有药物诱导的病因，许多不同的药物已被怀疑为TMA的原因。我们建立了评估药物与TMA因果关系的证据强度的标准，并系统地检索了所有已发表的药物诱导TMA的报告。我们识别了1569篇文章：检索了604篇进行综述，344篇报告了586例个体患者的可评价数据，43篇报告了46个患者组的可评价数据。描述了78种药物; 22种有证据支持与TMA的明确因果关系。三种药物占104例患者报告中的61例（奎宁，34例;环孢霉素，15例;他克莫司，12例）。另外20种药物有证据支持可能与TMA相关。这些标准和数据可以为临床医生评估疑似TMA患者提供支持。
Many patients with syndromes of thrombotic microangiopathy (TMA), including thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome, have been reported to have a drug-induced etiology, and many different drugs have been suspected as a cause of TMA. We established criteria to assess the strength of evidence for a causal association of a drug with TMA and systematically searched for all published reports of drug-induced TMA. We identified 1569 articles: 604 were retrieved for review, 344 reported evaluable data for 586 individual patients, 43 reported evaluable data on 46 patient groups. Seventy-eight drugs were described; 22 had evidence supporting a definite causal association with TMA. Three drugs accounted for 61 of the 104 patient reports with definite evidence (quinine, 34; cyclosporine, 15; tacrolimus, 12). Twenty additional drugs had evidence supporting a probable association with TMA. These criteria and data can provide support for clinicians evaluating patients with suspected TMA.