Agranulocytosis drug-induced

Agranulocytosis is a symptom complex characterized by marked decrease in the number of granulocytes, and by lesions of the throat and other mucous membranes of the gastrointestinal tract, and of the skin also called granulocytopenia and Schultz s disease. 

In 1922, Werner Schultz drew attention to a syndrome of unknown cause that he had observed especially in women of middle age, and which was characterized by severe sore throat, marked prostration, extreme reduction, or even complete disappearance of the granulocytes from the blood, and, in rapid succession, sepsis and death. He considered this to be a clinical entity that he called agranulocytosis. 

Acetaminophen Acetazolamide Acetylsalicylic acid Allopurinol P-Lactam antibiotics Benzodiazepines Brompheniramine Carbamazepine 

A number of mechanisms may produce drug-induced agranulocytosis. For example, chlorpromazine and other 

See Protease Inhibitors, Stavudine, Zalcitabine, Zidovudine. ALBUMIN 

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Adrenocorticoids topical antiinflammatory agents available as cream, gel, lotion, or ointment Aged patients altered pharmacokinetic profile of Agranulocytosis drug-induced Allergic rhinitis... 

Liu ZC, Uetrecht JP. Metabolism of ticlopidine by activated neutrophils implications for ticlopidine-induced agranulocytosis. Drug Metab Dispos 2000 28(7) 726-730. 

Mosyagin, L, Dettling, M., Roots, L, Mueller-Oerlinghausen, B. and Cascorbi, I. (2004) Impact of myeloperoxidase and NADPH-oxidase polymorphisms in drug-induced agranulocytosis. Journal of Clinical Psychopharmacology, 24, 613-617. 

Garbe, E. (2007) Non-chemotherapy drug-induced agranulocytosis. Expert Opinion on Drug Safety, 6, 323-335. 

Idiosyncratic drug-induced agranulocytosis update of an old disorder. European Journal of Internal Medicine, 17, 529-535. 

G. Other applications Neupogen may also be useful in preventing opportunistic diseases in patients infected with the human immunodehciency virus and for drug-induced agranulocytosis. The use of topical hlgrastim may be effective in reducing oral mucositis due to intensive chemotherapy. 

Outcomes have been reported in a consecutive series of 91 patients hospitalized with non-chemotherapy drug-induced agranulocytosis from 1985-2000 (34). All but two survived. Antithyroid drugs were the cause of agranulocytosis in 20% of cases. Univariate and multivariate analyses failed to reveal a specific effect of antithyroid drugs on the time to neutrophil recovery. In contrast, hemopoietic growth factor treatment was associated with speedier hematological recovery. 

Antithyroid drug-induced agranulocytosis. The usefulness of routine white blood cell count monitoring. Arch Intern... 

Tajiri J, Noguchi S. Antithyroid drug-induced agranulocytosis special reference to normal white blood cell count agranulocytosis. Thyroid 2004 14(6) 459-62. 

Maloisel F, Andres E, Kaltenbach G, Noel E, Koumarianou A. Prognostic factors of hematologic recovery in nonchemotherapy drug-induced agranulocytosis. Haematologica 2003 88 470-1. 

Hirsch D, Luboshitz J, Blum I. Treatment of antithyroid drug-induced agranulocytosis by granulocyte colony-stimulating factor a case of primum non nocere. Thyroid 1999 9(10) 1033-5. 

Fukata S, Kuma K, Sugawara M. Granulocyte colony-stimulating factor (G-CSF) does not improve recovery from antithyroid drug-induced agranulocytosis a prospective study. Thyroid 1999 9(1) 29-31. 

Andres E, Maloisel F, Ruellan A. Use of colony-stimulating factors for the treatment of antithyroid drug-induced agranulocytosis a retrospective study in twelve patients. Thyroid 2000 10(1) 103. 

Andres E, Maloisel F, Kurtz JE, Kaltenbach G, Alt M, Weber JC, Sibilia J, Schlienger JL, Blickle JF, Brogard JM, Dufour P. Modern management of non-chemotherapy drug-induced agranulocytosis a monocentric cohort study of 90 cases and review of the literature. Eur J Intern Med 2002 13(5) 324-8. 

Andres E, Kurtz JE, Perrin AE, Dufour P, Schlienger JL, Maloisel F. Haematopoietic growth factor in antithyroid-drug-induced agranulocytosis. QJM 2001 94(8) 423-8. 

The most serious side effects associated with acetazolamide are blood dyscrasias.Thrombocytopenia, agranulocytosis, and aplastic anemia have all occurred in patients taking acetazolamide however, drug-induced blood dyscrasias are extremely rare. 

Zapater P, Horga JF, Garcia A. Risk of drug-induced agranulocytosis the case of calcium dobesilate. Eur J Clin Pharmacol 2003 58(ll) 767-72. 

The G-CSF can cause severe pulmonary toxicity in patients who are not receiving concomitant chemotherapy. For example, several reports have suggested that G-CSF administration for drug-induced agranulocytosis can play a role in the development or worsening of the adult respiratory distress syndrome (ARDS) (33). 

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