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CHRONIC GRANULOCYTOPENIA CAUSED BY EXCESSIVE SPLENIC LYSIS OF GRANULOCYTES:  REPORT OF CASE

R. O. MUETHER, M.D.; L. T. MOORE, M.D.; J. W. STEWART, M.D.; G. O. BROUN, M.D.
JAMA. 1941;116(20):2255-2257. doi:10.1001/jama.1941.02820200025006.
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Since the first report of a case of acute agranulocytosis by Schultz in 19221 numerous additional reports have continued to appear in the literature. The syndrome of granulocytopenia may arise under diverse conditions and from varied causes and may run either an acute or a chronic course. Hence it is distinctly neither a clinical nor a pathologic entity.

The various etiologies have been the subject of much investigation. The frequency with which certain drugs and industrial poisons may act as depressants of bone marrow is well known. Nutritional deficiencies,2 bacterial toxins3 and hormonal imbalance4 have been found capable of producing the disease, at least experimentally. Acute agranulocytosis (which arises spontaneously and not as the obvious secondary effect of a known toxic agent) produces a more or less definite clinical picture and constant pathologic changes in the bone marrow.5

In 1939 Wiseman and Doan6 reported

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