关键词: 原发性骨髓纤维化, 脑出血, 芦可替尼

Abstract: A 74-year-old male patient with systemic lupus erythematosus who had been taking methylprednisolone tablets for a long time. He had primary myelofibrosis, and took ruxolitinib phosphate tablets 15 mg twice a day, hydroxyurea tablets 0.5 g twice a day, and stanzolol 2 mg three times a day. The patient was admitted to hospital due to bacterial pneumonia and invasive pulmonary aspergillosis. At that time, the white blood cell count was 19.29×10⁹/L, hemoglobin 70 g/L, and platelet count 113×10⁹/L. In the anti-bacterial aspect, imipenem and cilastatin sodium for injection, ceftazidime for injection, and cefoperazone and sulbactam sodium for injection were successively given. Voriconazole for injection was given for antifungal treatment. After that, the patient's body temperature returned to normal, and the symptoms of coughing and expectoration improved compared to before. On the 14th day of admission, the patient's family member noticed that the patient fell off the chair and landed on the ground, and then developed consciousness disorders. After that, the body temperature was normal, and the cough and sputum production were better than before. On the 14th day of admission, the family member found that the patient had slipped to the floor in his sitting position and had disturbance of consciousness. At that time, the white blood cell count was 11.69×10⁹/L, hemoglobin 88 g/L, and platelet count 63×10⁹/L; head CT showed extensive hemorrhage in the ventricular system. Cerebral hemorrhage is considered to be highly associated with ruxolitinib. His family member requested conservative treatment and died of respiratory and circulatory failure.

Key words: Primary myelofibrosis, Cerebral hemorrhage, Ruxolitinib