Agranulocytosis

The first drug documented as causing immunologically mediated agranulocytosis was aminopyrine. Leukoagglutinins to aminopyrine were demonstrated and granulocytopenia could be transferred passively by serum to normal volun- 

In preliminary clinical trials, 2 of 2,796 mirtazapine-treated patients developed agranulocytosis, and 1 developed severe neutropenia. All 3 patients recovered after medication discontinuation, and other possible etiologies were present in at least 1 of these individuals. Thirteen patients with pretreatment neutropenia did develop more severe neutropenia or agranulocytosis. Postmarketing evaluation to date has not established a causal relation between mirtazapine and agranulocytosis. Routine laboratory monitoring is not currently recommended. 

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Some rare toxic effects that may result from tocainide therapy are a lupus-fike syndrome, skin rash, pulmonary complications, and hematologic abnormalities, eg, agranulocytosis (1,2,24). 

Agranulocytosis—decrease in or lack of granulocytes, a type of white blood cell... 

Hematologic—neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, and aplastic anemia... 

BENZODIAZEPINES Carbamazepine may cause aplastic anemia and agranulocytosis. During treatment blood studies are performed frequently If evidence of bone marrow depression is obtained (eg, the patient s platelet... 

Agranulocytosis, headache, exfoliative dermatitis, granulocytopenia, thrombocytopenia, hepatitis,... 

The most serious adverse reaction associated with these drugs is agranulocytosis (decrease in the number of white blood cells [eg, neutrophils, basophils, and eosinophils]). Reactions observed with agranulocytosis include hay fever, sore throat, skin rash, fever, or headache Other major reactions include exfoliative dermatitis, granulocytopenia, aplastic anemia, hypoprothrombinemia, and hepatitis. Minor reactions, such as nausea, vomiting, and paresthesias, also may be seen. 

Agranulocytosis is potentially the most serious adverse reaction to methimazole and propylthiouracil. The nurse notifies the primary health care provider if fever, sore throat, rash, headache, hay fever, yellow discoloration of the skin, or vomiting occurs. 

The drug was subsequently reintroduced for treatment-resistant or treatment-intolerant patients in the UK and USA in 1990. The drug is completely free of extrapyramidal side effects but has to be monitored for the development of neutropenia and agranulocytosis. Other problems include sialorrhoea, sedation, reduction in seizure... 

Agranulocytosis is one of the most serious adverse effects of antithyroid drug therapy. 

Patients who receive antithyroid drugs must be monitored for adverse drug events such as agranulocytosis. 

These reactions usually take the form of hemolytic anemia, thrombocytopenia, granulocytopenia, or agranulocytosis. 

Agranulocytosis A severe form of neutropenia where the number of neutrophils (the major type of leucocyte or white blood cell) is very low, so reducing an individual s ability to fight infection. It is a potentially serious side effect of the atypical antipsychotic clozapine. 

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