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March 23, 1994, Vol 271, No. 12 >
ARTICLE | March 23, 1994

Agranulocytosis FREE

Neal S. Young, MD
[+] Author Affiliations

Reprint requests to Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10, Room 7C 103, Bethesda, MD 20892 (Dr Young).


JAMA. 1994;271(12):935-938. doi:10.1001/jama.1994.03510360061038
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Article
References

SELECTED CASES 

Patient 1  A 60-year-old man with moderately severe congestive heart failure secondary to cardiomyopathy was treated with an experimental inotropic drug, vesnarinone (Otsuka America, Rockville, Md), known to be associated with agranulocytosis. Blood cell counts were monitored weekly. Ten weeks after beginning treatment, the total white blood cell count, previously normal, was 2.6×109/L with an absolute neutrophil count of 1.282×109/L The patient was not symptomatic. The experimental drug was discontinued. Two days later the absolute neutrophil count was 0.396×109/L. The patient was hospitalized for observation. A bone marrow aspirate showed absence of mature granulocytes and myeloid precursor cells. The patient was treated with oral cephalexin. Fever occurred to a temperature of 38.6°C (101.4°F), leading to withdrawal of an intravenous catheter. Over a week both total white blood cell and neutrophil numbers returned to normal.

Patient 2  A 75-year-old woman with severe congestive

REFERENCES

1 +
Schultz W.  Ueber eigenartige Halserkrankungen. Dtsch Med Wochenschr . 1922;;48:1495-1496.
2 +
Kracke RR, Parker FP.  The relationship of drug therapy to agranulocytosis. JAMA . 1935;;105:960-966.
3 +
Madison FW, Squier TL.  The etiology of primary granulocytopenia (agranulocytic angina). JAMA . 1934;;102:755-759.
4 +
Moeschlin S, Wagner K.  Agranulocytosis due to the occurrence of leukocyte agglutinins. Acta Haematol . 1952;;8:29-41.
5 +
Pisciotta AV.  Agranulocytosis induced by certain phenothiazine derivatives. JAMA . 1969;;208: 1862-1868.
6 +
Pisciotta AV.  Drug induced agranulocytosis peripheral destruction of polymorphonuclear leukocytes and their marrow precursors. Blood Rev . 1990;; 4:226-237.
7 +
Young NS, Alter BF.  Agranulocytosis.  In: Aplastic Anemia, Acquired and Inherited . Philadelphia, Pa: WB Saunders Co; 1993;:227-264.
8 +
Rudovic R, Jelíc S.  Haematological aspects of drug-induced agranulocytosis. Scand J Haematol . 1972;;9:18-27.
9 +
Heimpel H.  Drug-induced agranulocytosis. Med Toxicol . 1988;;3:449-462.
10 +
Heit W, Heimpel H, Fischer A, Frickhofen N.  Drug-induced agranulocytosis: evidence for the commitment of bone marrow haematopoiesis. Scand J Haematol . 1985;;35:459-468.
11 +
Shastri KA, Logue GL.  Autoimmune neutropenia. Blood . 1993;;81:1984-1995.
12 +
Dunbar CE, Nienhuis AW.  The myelodysplastic syndromes.  In: Handin R, Lux S, Stossel T, eds. Blood: A Textbook of Hematology . Philadelphia, Pa: JB Lippincott. In press.
13 +
Kaufman DW, Kelly JP, Levy M, Shapiro S. The Drug Etiology of Agranulocytosis and Aplastic Anemia . New York, NY: Oxford University Press Inc; 1991;.
14 +
Böttiger LE, Furhoff AK, Holmberg L.  Drug-induced blood dyscrasias. Acta Med Scand . 1979;; 205:457-461.
15 +
Strom BL, Carson JL, Schinnar R, Snyder ES, Shaw M.  Descriptive epidemiology of agranulocytosis. Arch Intern Med . 1992;;152:1475-1480.
16 +
Currie MS, Weinberg JB, Rustagi PK, Logue GL.  Antibodies to granulocyte precursors in selective myeloid hypoplasia and other suspected autoimmune neutropenias: use of HL-60 cells as targets. Blood . 1987;;69:529-536.
17 +
Salama A, Schütz B, Kiefel V, Breithaupt H, Mueller-Eckhardt C.  Immune-mediated agranulocytosis related to drugs and their metabolites: mode of sensitization and heterogeneity of antibodies. Br J Haematol . 1989;;72:127-132.
18 +
Rouveix B, Coulombel L, Aymard JP, Chau F, Abel L.  Amodiaquine-induced immune agranulocytosis. Br J Haematol . 1989;;71:7-11.
19 +
Levitt LJ.  Chlorpropamide-induced pure white cell aplasia. Blood . 1987;;69:394-400.
20 +
Nebert DW, Gonzalez FJ.  P450 genes: structure, evolution, and regulation. Ann Rev Biochem . 1987;;56:945-993.
21 +
Gerson WT, Fine DG, Spielberg SP, Sensenbrenner LL.  Anticonvulsant-induced aplastic anemia: increased susceptibility to toxic drug metabolites in vitro. Blood . 1983;;61:889-893.
22 +
Weinshilboum R.  Pharmacogenetics of methyl conjugation and thiopurine drug toxicity. Prog Clin Biol Res . 1983;;135:167-181.
23 +
Price DA.  Acetylation.  In: Kalow W, Goedde HW, Agarwal DP, eds. Ethnic Differences in Reactions to Drugs and Xenobiotics . New York, NY: Alan R Liss; 1986;:209-242.
24 +
Hodinka L, Geher P, Meretey K, Gyodi EK, Petranyi GG, Bozsoky S.  Levamisole-induced neutropenia and agranulocytosis: association with HLA B27 leukocyte agglutinating and lymphocytotoxic antibodies. Int Arch Allergy Appl Immunol . 1981;; 65:460-464.
25 +
Singhvi SM, Duchin KL, Willard DA, McKinstry DN, Migdalof BH.  Renal handling of captopril: effect of probenecid. Clin Pharmacol Ther . 1982;;32:182-189.
26 +
Terkelsen KG, Grosser RC.  Estimating clozapine's cost to the nation. Hosp Community Psychiatry . 1990;;41:863-869.
27 +
Juliá A, Olona M, Revilla BE, et al.  Drug-induced agranulocytosis: prognostic factors in a series of 168 episodes. Br J Haematol . 1991;;79:366-371.
28 +
Laver J, Moore MAS.  Clinical use of recombinant human hematopoietic growth factors. J Natl Cancer Inst . 1989;;81:1370-1382.
29 +
Glaspy JA, Golde DW.  Clinical trials of myeloid growth factors. Exp Hematol . 1990;;18:1137-1141.
30 +
Rowe JM Rapport AP.  Hemopoietic growth factors: a review. J Clin Pharmacol . 1992;;32:486-501.
31 +
Feldman AM, Pepine CJ, Bristow MR, et al.  Incidence of vesnarinone-induced neutropenia: the US experience. Circulation . 1993;;88( (suppl 2) ):I-301. Abstract.
32 +
Tajiri J, Noguchi S, Okamura S, et al.  Granulocyte colony-stimulating factor treatment of antithyroid drug-induced granulocytopenia. Arch Intern Med . 1993;;153:509-514.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Schultz W.  Ueber eigenartige Halserkrankungen. Dtsch Med Wochenschr . 1922;;48:1495-1496.
2 +
Kracke RR, Parker FP.  The relationship of drug therapy to agranulocytosis. JAMA . 1935;;105:960-966.
3 +
Madison FW, Squier TL.  The etiology of primary granulocytopenia (agranulocytic angina). JAMA . 1934;;102:755-759.
4 +
Moeschlin S, Wagner K.  Agranulocytosis due to the occurrence of leukocyte agglutinins. Acta Haematol . 1952;;8:29-41.
5 +
Pisciotta AV.  Agranulocytosis induced by certain phenothiazine derivatives. JAMA . 1969;;208: 1862-1868.
6 +
Pisciotta AV.  Drug induced agranulocytosis peripheral destruction of polymorphonuclear leukocytes and their marrow precursors. Blood Rev . 1990;; 4:226-237.
7 +
Young NS, Alter BF.  Agranulocytosis.  In: Aplastic Anemia, Acquired and Inherited . Philadelphia, Pa: WB Saunders Co; 1993;:227-264.
8 +
Rudovic R, Jelíc S.  Haematological aspects of drug-induced agranulocytosis. Scand J Haematol . 1972;;9:18-27.
9 +
Heimpel H.  Drug-induced agranulocytosis. Med Toxicol . 1988;;3:449-462.
10 +
Heit W, Heimpel H, Fischer A, Frickhofen N.  Drug-induced agranulocytosis: evidence for the commitment of bone marrow haematopoiesis. Scand J Haematol . 1985;;35:459-468.
11 +
Shastri KA, Logue GL.  Autoimmune neutropenia. Blood . 1993;;81:1984-1995.
12 +
Dunbar CE, Nienhuis AW.  The myelodysplastic syndromes.  In: Handin R, Lux S, Stossel T, eds. Blood: A Textbook of Hematology . Philadelphia, Pa: JB Lippincott. In press.
13 +
Kaufman DW, Kelly JP, Levy M, Shapiro S. The Drug Etiology of Agranulocytosis and Aplastic Anemia . New York, NY: Oxford University Press Inc; 1991;.
14 +
Böttiger LE, Furhoff AK, Holmberg L.  Drug-induced blood dyscrasias. Acta Med Scand . 1979;; 205:457-461.
15 +
Strom BL, Carson JL, Schinnar R, Snyder ES, Shaw M.  Descriptive epidemiology of agranulocytosis. Arch Intern Med . 1992;;152:1475-1480.
16 +
Currie MS, Weinberg JB, Rustagi PK, Logue GL.  Antibodies to granulocyte precursors in selective myeloid hypoplasia and other suspected autoimmune neutropenias: use of HL-60 cells as targets. Blood . 1987;;69:529-536.
17 +
Salama A, Schütz B, Kiefel V, Breithaupt H, Mueller-Eckhardt C.  Immune-mediated agranulocytosis related to drugs and their metabolites: mode of sensitization and heterogeneity of antibodies. Br J Haematol . 1989;;72:127-132.
18 +
Rouveix B, Coulombel L, Aymard JP, Chau F, Abel L.  Amodiaquine-induced immune agranulocytosis. Br J Haematol . 1989;;71:7-11.
19 +
Levitt LJ.  Chlorpropamide-induced pure white cell aplasia. Blood . 1987;;69:394-400.
20 +
Nebert DW, Gonzalez FJ.  P450 genes: structure, evolution, and regulation. Ann Rev Biochem . 1987;;56:945-993.
21 +
Gerson WT, Fine DG, Spielberg SP, Sensenbrenner LL.  Anticonvulsant-induced aplastic anemia: increased susceptibility to toxic drug metabolites in vitro. Blood . 1983;;61:889-893.
22 +
Weinshilboum R.  Pharmacogenetics of methyl conjugation and thiopurine drug toxicity. Prog Clin Biol Res . 1983;;135:167-181.
23 +
Price DA.  Acetylation.  In: Kalow W, Goedde HW, Agarwal DP, eds. Ethnic Differences in Reactions to Drugs and Xenobiotics . New York, NY: Alan R Liss; 1986;:209-242.
24 +
Hodinka L, Geher P, Meretey K, Gyodi EK, Petranyi GG, Bozsoky S.  Levamisole-induced neutropenia and agranulocytosis: association with HLA B27 leukocyte agglutinating and lymphocytotoxic antibodies. Int Arch Allergy Appl Immunol . 1981;; 65:460-464.
25 +
Singhvi SM, Duchin KL, Willard DA, McKinstry DN, Migdalof BH.  Renal handling of captopril: effect of probenecid. Clin Pharmacol Ther . 1982;;32:182-189.
26 +
Terkelsen KG, Grosser RC.  Estimating clozapine's cost to the nation. Hosp Community Psychiatry . 1990;;41:863-869.
27 +
Juliá A, Olona M, Revilla BE, et al.  Drug-induced agranulocytosis: prognostic factors in a series of 168 episodes. Br J Haematol . 1991;;79:366-371.
28 +
Laver J, Moore MAS.  Clinical use of recombinant human hematopoietic growth factors. J Natl Cancer Inst . 1989;;81:1370-1382.
29 +
Glaspy JA, Golde DW.  Clinical trials of myeloid growth factors. Exp Hematol . 1990;;18:1137-1141.
30 +
Rowe JM Rapport AP.  Hemopoietic growth factors: a review. J Clin Pharmacol . 1992;;32:486-501.
31 +
Feldman AM, Pepine CJ, Bristow MR, et al.  Incidence of vesnarinone-induced neutropenia: the US experience. Circulation . 1993;;88( (suppl 2) ):I-301. Abstract.
32 +
Tajiri J, Noguchi S, Okamura S, et al.  Granulocyte colony-stimulating factor treatment of antithyroid drug-induced granulocytopenia. Arch Intern Med . 1993;;153:509-514.

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