Metamizole use by Latino immigrants: A common and potentially harmful home remedy
Metamizole use by Latino immigrants: A common and potentially harmful home remedy
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DOI：
10.1542/peds.109.6.e98
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发表时间：
2002-06-01
期刊：
影响因子：
8
通讯作者：
Byington, CL
中科院分区：
文献类型：
--
作者：
Bonkowsky, JL;Frazer, JK;Byington, CL
一个4岁的男孩表现为发热、脓毒性关节炎和持续性中性粒细胞减少。骨髓活检显示无肿瘤形成的证据。其他病史显示，患者在发病前接受安乃近治疗疼痛。安乃近是一种非甾体类兴奋剂，由于存在粒细胞缺乏症的风险，在美国被禁止使用，但在墨西哥和其他国家被广泛使用。在美国的拉丁美洲人越来越多，药物的广泛跨境转移引起了人们的关注，即安乃近的使用和相关并发症可能会变得更加频繁。在确定索引患者后，进一步询问显示患者的母亲先前因与安乃近使用相关的压倒性脓毒症住院。这些病例促使对城市儿科诊所的安乃近使用情况进行调查，结果显示35%的西班牙语拉丁裔家庭使用安乃近;其中25%的家庭在美国购买了药物。我们得出结论，安乃近的使用是常见的，可能是在移民拉丁美洲患者认识不足。美国的医生，特别是那些从事初级保健，血液学/肿瘤学和传染病的医生，必须了解安乃近在特定患者人群中的可用性和使用情况及其潜在的有害副作用。
A 4-year-old boy presented with fever, septic arthritis, and persistent neutropenia. Bone marrow biopsy revealed no evidence of neoplasia. Additional history disclosed that the patient had been given metamizole for pain before onset of his illness. Metamizole, a nonsteroidal antiinflammatory agent, is prohibited in the United States because of the risk of agranulocytosis but is widely used in Mexico and other countries. The increasing number of Latinos in the United States and the extensive cross-border transfer of medicines raise concerns that metamizole use and associated complications may become more frequent. After identification of the index patient, additional inquiry revealed that the patient's mother was hospitalized previously for overwhelming sepsis associated with metamizole use. These cases prompted an investigation of metamizole use in an urban pediatric clinic, which revealed that 35% of Spanish-speaking Latino families had used metamizole; 25% of these families had purchased the medication in the United States. We conclude that metamizole use is common and may be underrecognized in immigrant Latino patients. Physicians in the United States, especially those who practice primary care, hematology/oncology, and infectious diseases, must be aware of the availability and use of metamizole in specific patient populations and its potential for harmful side effects.