A 42-year-old female who has handled organic solvents in a plastic sign board factory for 2 and a half years, was given Thiamphenicol (1.5 gm/day for 3 days) by her family doctor because of common cold. About 2 and a half months later, jaundice and general malaise developed and she was admitted to Bokuto Metropolitan Hospital on July 28, 1976.
Laboratory findings were following: GOT 1145 U, GPT 858 U, LDH 355 U, Al-P 126 mu/m
l, HB antigen negative, HB antibody negative, Hb. 11.6 g/d
l, WBC 2,700/cmm, Platelet 22.8×10
4/cmm. Coagulation test was normal.
She made a favorable recovery from hepatitis since the middle of August when she began to suffer from gingival bleeding and high fever. Severe pancytopenia (WBC 1,000/cmm, Hb. 8.4 g/d
l, Retic. 0%, Platelet. 0.8×10
4) and hypoplastic marrow were noticed. After some blood cultures, which yielded E. Coli, Predonisolone 60 mg/day, CB-PC 21 gm/day and Gentamicin 120 mg/day were administered from 20th of August. She died on 4th of September because of septicemia.
Autopsy findings revealed fatty marrow, rather healed hepatitis and generalized candidiasis. Thiamphenicol is believed never to raise irreversible aplastic anemia, but this case is thought to be very similar to that of chloramphenicol-hepatitis-aplastic anemia syndrome. The relationship between thiamphenicol, benzol, hepatitis and aplastic anemia was discussed.
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