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Fatal Pancytopenia and Acetazolamide Therapy

Garth W. Englund, MD
JAMA. 1969;210(12):2282. doi:10.1001/jama.1969.03160380096028.
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To the Editor:—  Acetazolamide (Diamox), a sulfonamide and a potent carbonic anhydrase inhibitor, is used in the control of fluid secretion and in the promotion of diuresis in cases of fluid retention. Adverse reactions to sulfonamides are well known, however, a brief review of the literature revealed only two previously reported cases of bone marrow depression due to acetazolamide, one with recovery,1 and one fatal.2 To these is added one of severe, fatal bone marrow depression with leukopenia, thrombocytopenia, and anemia after 3 1/2 months of treatment for glaucoma with 500 mg twice daily.

Report of a Case:—  A 66-year-old man was hospitalized because of severe pharyngitis, stomatitis, and cheilitis which had an onset approximately five days prior to hospitalization and had not responded to treatment with lincomycin and penicillin. The patient had been well prior to this except for recent onset of weakness, fatigue, mild dyspnea, and


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