International Journal of Cardiovascular ResearchISSN: 2324-8602

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Drug-Induced Bone Marrow Aplasia Revealed by Severe Hemorrhagic Stroke after Taking Amiodarone: A Case Report

Aplastic anemia is defined by the disappearance or rarefaction of the normal hematopoietic tissue of the marrow leading to quantitative bone marrow failure; the diagnosis of aplastic anemia is based on clinicobiological criteria; multiple etiologies may be involved, in particular drug causes, in particular amiodarone. Mrs. SZ, 45 years old; follow-up for VT on ischemic heart disease put on amiodarone for 6 months. Symptoms dated back 2 days before admission with the onset of disturbance of consciousness and generalized tonic-clonic seizures. On admission neurologically: the patient had 9/15 GCS, pupils in tight miosis, no deficit, no convulsion; with a stable hemodynamic and respiratory state The remainder of the examination showed gingivorrhagia with bruising of the lower limbs. Complementary examinations had found: an aspect of a parafalcorial hemorrhagic stroke complicated by major tri ventricular hydrocephalus with ventricular flooding on the CT scan. With pancytopenia: Hb: 6.4g / dl, GB 890e; PNN 30e; Lc: 780e; Pq: 4000e, absence of Blasts, a myelogram and a BOM showed a desert marrow with cytogenetic and molecular study, the rest of the work-up ruled out the other etiologies of AM and the drug etiology was retained. Treatment was mainly symptomatic, administration of tranexamic acid, transfusion of 2 GC of 5 CPQ; management of ACSOS; and discontinuation of the drug. The course was marked by the regression of pancytopenia. The occurrence of aplasia under amiodarone is a fairly rare occurrence. According to the recommendations, the severity criteria are essentially biological; the severity of the aplastic anemia in this patient is determined by the 2 criteria present: PNN less than 500th and the platelets less than 20,000th; the severity of this case is greater given the severe added stroke. Treatment in severe aplasia consists of the administration of immunosuppressants (cyclosporine, high doses of corticosteroid, anti-lymphocytic serum) with 40% remission Or a hematopoietic stem cell transplant with 70% remission.

Special Features

Full Text


Track Your Manuscript

Media Partners