Hematologic complications

Laboratory studies have provided insights into the immune mechanisms underlying the hematological complications of antithyroid drugs (30). Sera from five... 

Amphotericin in combination with flucytosine results in an increased risk of hematological complications, because amphotericin often impairs renal function, causing retention of flucytosine (10). 

Bang NU, Kammer RB. Hematologic complications associated with betalactam antibiotics. Rev Infect Dis 1983 5(Suppl) 380. 

Amphotericin in combination with flucytosine results in an increased risk of hematological complications, because amphotericin often impairs renal function, causing retention of flucytosine (7). This combination also delays hematopoietic recovery after cytotoxic chemotherapy it should not be used as empirical antifungal therapy in febrile patients with neutropenia (27). 

Patients who develop cholestatic jaundice during chronic parenteral nutrition can develop significant hematological complications due to hypocupremia. 

Although the hematological complications of pyrimethamine are generally a consequence of therapeutic use, long-term prophylactic treatment with pyrimethamine and dapsone in malaria could well involve an increased risk of megaloblastic anemia in patients whose nutritional state is not optimal (SEDA-13, 812). 

Various other hematological complications have been observed during ticlopidine treatment (5). They include neutropenia, agranulocytosis, thrombocytopenia, aplastic anemia, pancytopenia, and thrombotic thrombocytopenic purpura (6). These reactions are potentially severe and some are fatal. Major bleeding is rare. Among 188 cases of hematological comphcations associated with ticlopidine and reported to the US Food and Drug Administration, 36 (19%) resulted in death (7). 

Zidovudine is a nucleoside analogue reverse transcriptase inhibitor. Its adverse effects include hematological complications, severe headache, insomnia, confusion, nausea, vomiting, abdominal discomfort, myalgia (myopathy), and nail pigmentation (1). 

Treatment is symptomatic and supportive for wound care (similar to loxoscelism) and hematologic complications. Surgical graft repair for severe ulcerative lesions may be warranted. 

Pyrimethamine [2,4-diamino-5-(p-chlorophenyl)-6-ethylpyrimidine] is most active against protozoal dihydrofolate reductase. However, there is only a small margin between the dose required to kill the organisms and that which will affect the host. It is most commonly used in the treatment of toxoplasmosis hut more recently has heen used at a lower and safer dose of 25 mg weekly for malarial prophylaxis. This dose is unlikely to produce any adverse hematological complications in the short term. Larger doses are required to treat toxoplasmosis and where it exceeds 25 mg daily a megaloblastic anemia will develop in many of the patients so treated (Nl). 

Drug allergy may develop when Hj antagonists are given orally but results more commonly from topical application. Allergic dermatitis is not uncommon other hypersensitivity reactions include dmg fever and photosensitization. Hematological complications such as leukopenia, agranulocytosis. 

The symptoms of acute intoxication may be very similar to that of other diseases (Box 5.3), may often lead to a misdiagnosis and, at times, death. On the other hand, some metabolic disorders can predispose a neonate to frequent neonatal period complications such as infections like E. coli sepsis in children with galactosemia or hematological complications such as central nervous system hemorrhage in hyperammonemia or thrombocytopeiua due to bone marrow suppresion in some aminoacidurias [2,7],... 

D. D. McCarthy and T. M. Chalmers, Hematological complications of phenylbutazone therapy Review of the literature and report of two cases, CMAJ, 1964, 90, 1061-1067. 

---