Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages*
Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages*
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DOI：
10.1111/j.1600-0609.2010.01415.x
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发表时间：
2010-05-01
影响因子：
3.1
通讯作者：
Terrell, Deirdra R.
中科院分区：
文献类型：
--
作者：
Royer, Derek J.;George, James N.;Terrell, Deirdra R.
背景：血小板减少症是许多药物公认的不良反应。然而，除了含奎宁饮料引起血小板减少症的报道外，血小板减少症与补充/替代药物、草药、营养补充剂、食品和饮料的关联很少被描述。 目的：系统地识别所有已发表的与这些物质相关的血小板减少症报告，并评估支持其与血小板减少症因果关系的证据。方法：检索 11 个数据库以识别相关已发表的报告。为文章选择和评估定义了先验标准。每一篇选定的文章均由三位作者独立评估，以记录标准的存在，并确定所报告物质与血小板减少症之间因果关系的证据水平。 结果：确定了 27 篇文章，报告了 25 种物质（奎宁除外）发生血小板减少症的情况。然而，只有六篇文章描述了五种物质（牛奶、酸果蔓汁、果汁、羽扇豆和芝麻酱），报告了支持与血小板减少症存在因果关系的明确证据的临床数据。四篇文章提供了四种其他物质的可能证据，五篇文章提供了五种其他物质的可能证据。在其余的文章中，与血小板减少症的关联不太可能，或者这些文章被排除在审查之外。 结论：描述补充/替代药物、草药、营养补充剂、食品和饮料的明确或可能证据的血小板减少症报告很少见。这些物质引起的血小板减少症是否不常见或未被识别尚不清楚。
Background:Thrombocytopenia is a well-recognized adverse effect of many drugs. However, the association of thrombocytopenia with complementary/alternative medicines, herbal remedies, nutritional supplements, foods, and beverages has been rarely described, except for reports of thrombocytopenia caused by quinine-containing beverages.Objectives:To systematically identify all published reports of thrombocytopenia associated with these substances and to assess the evidence supporting their causal association with thrombocytopenia.Methods:Eleven databases were searched to identify relevant published reports. A priori criteria were defined for article selection and assessment. Each selected article was independently assessed by the three authors to document the presence of the criteria and determine the level of evidence for a causal association of the reported substance with thrombocytopenia.Results:Twenty-seven articles were identified that reported the occurrence of thrombocytopenia with 25 substances (other than quinine). However, only six articles describing five substances (cow's milk, cranberry juice, Jui [Chinese herbal tea], Lupinus termis bean, and tahini [pulped sesame seeds]) reported clinical data supporting definite evidence of a causal association with thrombocytopenia. Four articles provided probable evidence for four additional substances, and five articles provided possible evidence for five additional substances. In the remaining articles, the association with thrombocytopenia was unlikely or the articles were excluded from review.Conclusions:Reports of thrombocytopenia describing definite or probable evidence for an association of a complementary/alternative medicines, herbal remedies, nutritional supplements, foods, and beverages are rare. Whether the occurrence of thrombocytopenia with these substances is uncommon or unrecognized is unknown.