Blood ribavirin concentration in high‐dose ribavirin for adenovirus‐induced haemorrhagic cystitis – a case report
Blood ribavirin concentration in high‐dose ribavirin for adenovirus‐induced haemorrhagic cystitis – a case report
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高剂量利巴韦林治疗腺病毒引起的出血性膀胱炎的血液利巴韦林浓度——病例报告
DOI：
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发表时间：
2008
影响因子：
2
通讯作者：
Y. Kohda
中科院分区：
文献类型：
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作者：
M. Homma;Y. Inoue;Y. Hasegawa;H. Kojima;Y. Kohda
对腺病毒引起的干细胞移植后出血性膀胱炎患者给予大剂量口服利巴韦林后，监测了利巴韦林的血药浓度。静脉注射丙种球蛋白(15 g/3 d)和大剂量利巴韦林(RBV；90 0 0 mg/4 d)联合应用，可使利巴韦林血药浓度达到2 4·3 μm，达到病毒清除的目的。高水平的红细胞利巴韦林(1085 μm；主要作为磷酸化代谢物)半衰期长(15 天)导致严重贫血，在停止利巴韦林治疗后需要多次输血2 周。由于停用利巴韦林后，红细胞中的磷酸化利巴韦林仍有较高的蓄积量，因此在RBV后至少4 周内仍有必要输血和密切监测血红蛋白水平。
Blood ribavirin concentration was monitored after the administration of high‐dose oral ribavirin in a case of adenovirus‐induced haemorrhagic cystitis post‐stem‐cell transplantation. Combination use of intravenous gamma immunoglobulin (15 g/3 days) and high‐dose ribavirin (RBV; 9000 mg/4 days) provided plasma ribavirin concentration of 24·3 μm and achieved virus eradication. High level of erythrocyte ribavirin (1085 μm; mostly as phosphorylated metabolites) with long half‐life (15 days) caused severe anaemia, which required several blood transfusions for 2 weeks after the cessation of the ribavirin treatment. It was suggested that blood transfusion and intensive haemoglobin level monitoring is necessary for at least 4 weeks after the RBV, because of the high accumulation of phosphorylated ribavirin in erythrocytes even after stopping ribavirin administration.