The Outcome of Aplastic Anaemia Associated with Terbinafine Therapy

Farhan Khalid; Sai Rakshith Gaddameedi; Ahmad Al-Alwan; Husam Bader; Doantrang Du; Trishala Meghal

doi:10.12890/2023_004142

The Outcome of Aplastic Anaemia Associated with Terbinafine Therapy

Eur J Case Rep Intern Med. 2023 Dec 20;11(1):004142. doi: 10.12890/2023_004142. eCollection 2024.

Authors

Farhan Khalid¹, Sai Rakshith Gaddameedi¹, Ahmad Al-Alwan¹, Husam Bader¹, Doantrang Du¹, Trishala Meghal²

Affiliations

¹ Department of Internal Medicine, Monmouth Medical Center, New Jersey, USA.
² Department of Hematology/Oncology, Monmouth Medical Center, New Jersey, USA.

Abstract

Onychomycosis (OM), a widespread fungus that affects the toenails and/or fingernails, causes a large amount of morbidity and is very frequent in the general population. The best treatment is systemic antifungals. Terbinafine is a potent antifungal drug that works by targeting the keratin and lipids found in fungi. In the United States, the prevalence of this nail ailment ranges from 2% to 14%; it is 5.5% globally. Here, we describe a case of aplastic anaemia linked to oral terbinafine use. Clinicians should be aware of this rare adverse effect and early discontinuation of the treatment is required to prevent significant morbidity and mortality.

Learning points: Aplastic anaemia is a rare side effect of terbinafine.Patients should be advised about this, and serial laboratory testing can be helpful for those who are on a long-term course of terbinafine.Early diagnosis and start of treatment can lead to a favourable outcome.

Keywords: Aplastic anemia; fungi; onychomycosis; pancytopenia; terbinafine; thrombocytopenia.