A Case of a Severe Burn Patient Showing Leukopenia and Thrombocytopenia Treated with Histamine H₂ Antagonists and Silver Sulfadiazine

—The Serum Silver Levels and the Adverse Effects of Combined Therapy—

Abstract

A 57-year-old female patient suffering from severe burns (grade II and III over 80% of the body and a burn index of 70%) developed leukopenia and thrombocytopenia after 3 days of treatment with famotidine and silver sulfadiazine. The white blood cell (WBC) and platelet counts later recovered after treatment was tapered. The serum silver levels were determined to range from 224ng (at the time of the lowest WBC count) to 161 ng/ml (after recovery). Even after recovery of the WBC and platelet counts, their levels still remained high. These data therefore suggest that adverse effects may be caused by the combined treatment of famotidine and silver sulfadiazine.