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报告1例患者因将D-青霉胺误为青霉素而大量服用。服前1个月血细胞计数正常,但血小板明显减少。服药后有许多溶血的证据:网织红细胞明显增多,间接胆红质水平增高、骨髓晚幼红细胞增生、结合珠蛋白水平降低、周围血片中出现有核的红细胞及突然发生严重贫血等。经停用D-青霉胺并用激素治疗后溶血和血小板减少都明显改善,血细胞计数恢复正常。有人曾提出红细胞中G-6-PD缺乏患者用青霉胺时可出现溶血性贫血的副作用。是本例G-6-PD为11.5国际单位/克血红蛋白(正常5～10)。引起溶血的另一种解释是青霉胺为β,β-二甲基半胱胺酸-α-巯基氨基酸。溶血是青霉素并不少见的
One patient was reported to be taking a large amount of medication because of mistakeing D-penicillamine as penicillin. 1 month before serving blood cell count was normal, but significantly reduced platelets. After taking medicine there are many evidences of hemolysis: reticulocyte increased significantly, increased levels of indirect bilirubin, bone marrow late erythroblast hyperplasia, reduced levels of haptoglobin, peripheral blood cells appear in the nucleated red blood cells and sudden severe anemia. After discontinuation of D-penicillamine and hormone therapy hemolysis and thrombocytopenia were significantly improved, the blood count returned to normal. It has been suggested that red blood cells in G-6-PD deficiency patients with penicillamine can occur when the side effects of hemolytic anemia. In this case, G-6-PD is 11.5 IU / g hemoglobin (normal 5 to 10). Another explanation for hemolysis is that penicillamine is β, β-dimethylcysteine-α-mercaptoamino acid. Hemolysis is not uncommon for penicillin