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Internal Medicine (Tokyo, Japan) Sep 1997We report a 64-year-old male with granulocytopenia and dermatitis due to cyanamide treatment. We administered cyanamide for alcoholism. After about one month he suffered...
We report a 64-year-old male with granulocytopenia and dermatitis due to cyanamide treatment. We administered cyanamide for alcoholism. After about one month he suffered from scaly erythema over his whole body and granulocytopenia (granulocyte; 140/microliter) with maturation arrest in bone marrow. After cessation of cyanamide and the start of granulocyte colony-stimulating factor administration, the skin eruption ameliorated gradually, and the peripheral blood granulocyte counts increased. Cyanamide showed positive results in the drug lymphocyte stimulation test (198%) and the patch test led to the diagnosis of granulocytopenia and dermatitis induced by cyanamide. After restarting glibenclamide and diazepam administration, his granulocytopenia did not reoccur. To our knowledge, this is the first report of a case with granulocytopenia induced by cyanamide.
Topics: Agranulocytosis; Alcoholism; Antiemetics; Cyanamide; Dermatitis; Diazepam; Glyburide; Granulocyte Colony-Stimulating Factor; Humans; Hypoglycemic Agents; Male; Middle Aged; Patch Tests
PubMed: 9313109
DOI: 10.2169/internalmedicine.36.640 -
Annales de Biologie Clinique Dec 2018Adult neutropenia, defined as a blood neutrophil count below 1.5 G/L, is a common condition. The most common cause of acute neutropenia is a drug-related reaction or an... (Review)
Review
Adult neutropenia, defined as a blood neutrophil count below 1.5 G/L, is a common condition. The most common cause of acute neutropenia is a drug-related reaction or an acute infectious disease. In chronic forms many etiologies are possible, sometimes poorly-defined, requiring precise explorations. The purpose of this article is to recall the required criteria for exploring neutropenia and to point out the algorithm of explorations in order to find the cause. Etiologies of acute and chronic forms are also detailed.
Topics: Adult; Age of Onset; Checklist; Diagnosis, Differential; Humans; Neutropenia; Risk Factors
PubMed: 30543190
DOI: 10.1684/abc.2018.1393 -
Canadian Medical Association Journal Dec 1964
Topics: Agranulocytosis; Aminopyrine; Dipyrone; Humans
PubMed: 14226100
DOI: No ID Found -
The American Journal of Case Reports Sep 2017BACKGROUND Sinomenine hydrochloride is an alkaloid that is extracted from the Chinese herbal plant Sinomenium acutum, and is used as a herbal medicine in the treatment...
BACKGROUND Sinomenine hydrochloride is an alkaloid that is extracted from the Chinese herbal plant Sinomenium acutum, and is used as a herbal medicine in the treatment or rheumatic disease. This report is the first to describe a case of sinomenine hydrochloride-induced agranulocytosis. CASE REPORT A 44-year-old woman with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) was treated with sinomenine hydrochloride and developed agranulocytosis with a neutrophil count of 0.01×10^9/L. She subsequently developed an opportunistic bacterial infection. Bone marrow aspiration showed a severe reduction in the proportion of mature granulocytes. The patient discontinued sinomenine hydrochloride therapy and was treated with granulocyte colony-stimulating factor (G-CSF) and antibiotics. The patient showed a return to normal granulocyte levels within ten days of discontinuing treatment with sinomenine hydrochloride. CONCLUSIONS The findings of this case report show that monitoring of bone marrow function and granulocyte levels should be performed during treatment with sinomenine hydrochloride.
Topics: Adult; Agranulocytosis; Antirheumatic Agents; Drugs, Chinese Herbal; Female; Humans; Morphinans
PubMed: 28874654
DOI: 10.12659/ajcr.904519 -
Canadian Medical Association Journal May 1984A 46-year-old man with pentazocine-induced agranulocytosis is described. In previously reported cases of a complete absence of mature neutrophils in the peripheral blood...
A 46-year-old man with pentazocine-induced agranulocytosis is described. In previously reported cases of a complete absence of mature neutrophils in the peripheral blood and bone marrow the patients had undergone marrow-depressing treatment with radiation and antineoplastic drugs. This case is unique in that the patient had complete agranulocytosis without predisposing factors.
Topics: Agranulocytosis; Cephalothin; Gentamicins; Humans; Leukocyte Count; Male; Middle Aged; Neutrophils; Pentazocine
PubMed: 6713337
DOI: No ID Found -
The Kaohsiung Journal of Medical... Nov 2003A 43-year-old woman with liver cirrhosis and hepatocellular carcinoma was admitted for the chief problem of ascites. Laboratory data revealed a leukocyte count of 3.8 x... (Review)
Review
A 43-year-old woman with liver cirrhosis and hepatocellular carcinoma was admitted for the chief problem of ascites. Laboratory data revealed a leukocyte count of 3.8 x 10(9)/L on the second day of admission. Spironolactone was prescribed for diuresis beginning on the third day. Routine blood tests on the tenth day disclosed marked leukopenia (1.8 x 10(9)/L). Four days later, the leukocyte count was still 1.8 x 10(9)/L and a differential count revealed agranulocytosis (neutrophils, 0.25 x 10(9)/L). Eight days after withdrawal of spironolactone, the leukocyte count returned to normal (leukocytes, 4.9 x 109/L; neutrophils, 1.76 x 10(9)/L). On review of the patient's clinical condition, concurrent medication, and previous reports, we highly suspected that this episode of agranulocytosis was caused by spironolactone. Unlike four previously reported cases, this one did not involve furosemide, which is reported to be associated with leukopenia and agranulocytosis.
Topics: Adult; Agranulocytosis; Female; Humans; Spironolactone
PubMed: 14658487
DOI: 10.1016/S1607-551X(09)70509-1 -
Schmerz (Berlin, Germany) Feb 2017Dipyrone (metamizole) is a non-opioid analgesic commonly used in Germany, which can, in very rare cases, cause life-threatening agranulocytosis. The prescribing... (Review)
Review
BACKGROUND
Dipyrone (metamizole) is a non-opioid analgesic commonly used in Germany, which can, in very rare cases, cause life-threatening agranulocytosis. The prescribing information calls for regular monitoring of the differential blood count in cases of long-term treatment. However, there is uncertainty about how this testing should be handled in practice.
OBJECTIVES
Which recommendations can be derived from the published literature for evaluating blood cell counts during treatment with metamizole and which other options for monitoring exist?
METHODS
Data from recent epidemiological studies, reviews, and spontaneously reported cases were evaluated.
RESULTS
Agranulocytosis can emerge at highly variable intervals ranging from the first day of metamizole treatment to months after treatment has begun. As a result, there is no conclusive, evidence-based recommendation for the time intervals at which blood cell counts should be tested. Therefore, the onset of clinical symptoms should be used as trigger for monitoring blood cell counts to enable early diagnosis and avoid agranulocytosis-related complications. In addition to general symptoms like fever, sore throat, fatigue, and muscle pain, mucosal ulcerations, severe angina, and systemic infections leading to sepsis are typical of agranulocytosis.
CONCLUSIONS
Providing patients and medical staff with better information about early symptoms of agranulocytosis could be a sensible way to prevent complications. Any suspicion of agranulocytosis should immediately lead to a differential blood count and to the withdrawal of all drugs possibly associated with agranulocytosis. Patients should be monitored and treated according to the severity of their symptoms.
Topics: Agranulocytosis; Anti-Inflammatory Agents, Non-Steroidal; Blood Cell Count; Dipyrone; Drug Monitoring; Early Diagnosis; Humans; Long-Term Care
PubMed: 27766404
DOI: 10.1007/s00482-016-0160-3 -
British Journal of Haematology Feb 2020
Review
Topics: Adult; Agranulocytosis; Female; Humans; Lenograstim; Leukocyte Count; Pregnancy; Pregnancy Complications, Hematologic
PubMed: 31743422
DOI: 10.1111/bjh.16269 -
BMJ Case Reports Jan 2019A 26-year-old man with history of schizophrenia was admitted for neutropaenia. He was started on clozapine 3 months prior to admission. As a result he had weekly...
A 26-year-old man with history of schizophrenia was admitted for neutropaenia. He was started on clozapine 3 months prior to admission. As a result he had weekly monitoring of his blood counts and on day of admission was noted to have an absolute neutrophil count (ANC) of 450 cells/μL. He was admitted for clozapine-induced agranulocytosis. Clozapine was held and the patient was started on granulocyte colony-stimulating factor (G-CSF) filgrastim and received two doses without any signs of ANC recovery. On further review, it was noted that the absolute monocyte count (AMC) was also low and tracked with the trend of ANC. We then theorised that the impact of clozapine was on a haematopoietic precursor (colony-forming unit granulocyte-macrophage, CFU-GM) which gives rise to both monocytic and myeloid lineages. Therefore, sargramostim GM-CSF was started. After two doses, the ANC and AMC started trending up and by the third dose, both counts had fully recovered. He was discharged from the hospital and there are no plans to rechallenge with clozapine. Thus, we demonstrate a case of monocytopenia accompanying clozapine-induced agranulocytosis with successful use of GM-CSF. At least in this case, the target of the clozapine injury appears to be the CFU-GM, explaining the rapid and full response to GM-CSF after lack of response to G-CSF.
Topics: Adult; Agranulocytosis; Clozapine; Filgrastim; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Male; Monocytes; Neutropenia; Recombinant Proteins; Schizophrenia; Treatment Outcome
PubMed: 30661042
DOI: 10.1136/bcr-2018-226016 -
Proceedings of the Royal Society of... Aug 1951
Topics: Agranulocytosis; Hepatomegaly; Humans; Leukopenia; Liver; Neutropenia; Splenomegaly
PubMed: 14864585
DOI: No ID Found