{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:44:11Z","timestamp":1783529051996,"version":"3.55.0"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Sinomenine, derived from\n                    <jats:italic>Sinomenium acutum<\/jats:italic>\n                    , is widely used in inflammatory diseases. However, its risk of inducing agranulocytosis is not widely appreciated. We report a life\u2010threatening case in a 40\u2010year\u2010old woman with chronic kidney disease (CKD; baseline estimated glomerular filtration rate [eGFR] as low as 36\u2009mL\/min\/1.73\u2009m\n                    <jats:sup>2<\/jats:sup>\n                    ) who developed severe agranulocytosis (absolute neutrophil count [ANC] &lt;\u20090.01\u2009\u00d7\u200910\n                    <jats:sup>9<\/jats:sup>\n                    \/L) following 35\u2009days of sinomenine hydrochloride therapy. Complications included sepsis and acute kidney injury. A bone marrow biopsy confirmed granulocytic hypoplasia. Management consisted of immediate drug cessation, antibiotics, protective isolation, recombinant human granulocyte colony\u2010stimulating factor, and intravenous immunoglobulin. Neutrophil counts fully recovered within 11\u2009days. This case highlights the potential for severe hematological toxicity from all sinomenine preparations and suggests that CKD may be a risk factor. We recommend close monitoring of full blood counts for at least the initial 6\u2009weeks of therapy, with heightened vigilance in patients with renal impairment.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.71853","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T10:09:28Z","timestamp":1768385368000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Life\u2010Threatening Agranulocytosis Induced by Sinomenine Hydrochloride in Chronic Kidney Disease: A Case Report and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"given":"Ping","family":"Xin","sequence":"first","affiliation":[{"name":"Tianjin University of Traditional Chinese Medicine  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Tianjin University of Traditional Chinese Medicine  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-1484","authenticated-orcid":false,"given":"Bin","family":"Fu","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.945129"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.15586\/aei.v53iSP1.1204"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e29976"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2023.110227"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2022.1041006"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.19540\/j.cnki.cjcmm.20230418.501"},{"key":"e_1_2_14_8_1","first-page":"2030","article-title":"Studies on the Syntheses of Heterocyclic Compounds. 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[Agranulocytosis After Use of Metamizole \u2013 An Underestimated Risk?]","volume":"99","author":"Schinz K.","year":"2020","journal-title":"Laryngo\u2010Rhino\u2010Otologie"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000932"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(97)80040-6"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2017.04.003"},{"issue":"1","key":"e_1_2_14_39_1","first-page":"237","article-title":"Inhibitory Effect of Sinomenine on HepG2 Cells","volume":"45","author":"Liu B.","year":"2023","journal-title":"Chinese Traditional Patent Medicine"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/14756366.2022.2096020"},{"issue":"1","key":"e_1_2_14_41_1","first-page":"51","article-title":"Effects of Sinomenine on Proliferation and Apoptosis in Human Lung Cancer Cell Line NCI\u2010H460 in Vitro","volume":"3","author":"Jiang T.","year":"2010","journal-title":"Molecular Medicine Reports"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.b21-01063"},{"key":"e_1_2_14_43_1","unstructured":"X. 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