Fatal Agranulocytosis and Fournier’s Gangrene due to the Use of Metamizole

Aslan, Nagehan; Yıldızdaş, Dinçer; Horoz, Özden Özgür; Özden, Önder

doi:10.1007/s12098-018-2799-5

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…Thus, the recommendation was that dipyrone should not be the first choice for pediatric treatment of fever [25]. Although epidemiological or clinical studies evaluating the risk of dipyrone-related agranulocytosis in children are scarce and inconclusive, it should not be overlooked, as there is evidence via case reports, such as the one that occurred with a 4-year-old child after dipyrone use for fever [52] and another fatal outcome, in which a 12-year-old adolescent died from complications of Fournier's gangrene and septic shock due to agranulocytosis induced by the consumption of 8 g of dipyrone two weeks earlier [53].…”

Section: Dipyrone In Childrenmentioning

confidence: 99%

One hundred years of dipyrone (metamizole): the recent evidence on its safety

Malheiro

Viana²,

Nascimento³

et al. 2023

PRW

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Dipyrone is a non-opioid analgesic drug used for fever and many types of pain. Due to the risk of induced agranulocytosis, it was banned in the early 1980s in several countries, but is still widely used in Brazil, Mexico, China and others. This study is a systematic review of literature focusing on the recent evidence about dipyrone safety. To this, a literature search was performed for epidemiological studies published between 2015 and 2022, in English, German, Portuguese, and Spanish languages. From the 30 articles that met the inclusion criteria, most of them consisted in observational studies (n = 27). In children, the frequency of adverse events with dipyrone is low, but can affect the renal and circulatory systems. During pregnancy, the drug doesn't seem to be related to teratogenic abnormalities. Agranulocytosis is still a matter of debate. However, the occurrence is rare, with an estimated risk of 1:1,602. In adults, dipyrone is related to several adverse effects on renal, hepatic, respiratory and epidermal systems. Thus, dipyrone seems to have a low incidence of adverse effects, but some can be considered of high severity. Especially in children, elderly and patients who need treatment for long periods, other analgesic options should be evaluated.

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Section: Dipyrone In Childrenmentioning

confidence: 99%

One hundred years of dipyrone (metamizole): the recent evidence on its safety

Malheiro

Viana²,

Nascimento³

et al. 2023

PRW

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Grundzüge des perioperativen Schmerzmanagements bei Säuglingen, Kindern und Jugendlichen

Reuß

Schramm

2020

Monatsschr Kinderheilkd

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Metamizole Use in Children: Analysis of Drug Utilisation and Adverse Drug Reactions at a German University Hospital between 2015 and 2020

et al. 2021

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Background Metamizole use is controversially discussed due to its potentially serious adverse drug reactions (ADRs). In Germany, however, it remains a popular analgesic and antipyretic drug. Objective The aim of this study was to discuss the safety profile of metamizole in children by analysing the inpatient prescription patterns and presenting the metamizole-related ADRs at a paediatric hospital between 2015 and 2020. Methods Metamizole utilisation data were retrospectively analysed from electronic medical records. ADRs were prospectively recorded via the hospital’s stimulated reporting system and analysed accordingly. Patients aged < 18 years admitted to one of the general wards of the department of paediatrics and adolescent medicine of a German university hospital between June 2015 and May 2020 who received at least one drug therapy within their inpatient stay were included in the analysis. Causality of ADRs was rated according to the World Health Organisation causality assessment. Results In 31.7% (3759/11,857) of the inpatient stays of 7809 patients, metamizole was administered. Metamizole exposure was highest in adolescents (37.9%) and lowest in newborns (9.9%). Overall, metamizole was administered parenterally in about 90%. Three cases of agranulocytosis, one allergic shock and one rash with possible or higher causality to metamizole treatment were reported. Three of these occurred prior to hospitalisation. All patients recovered without remaining harm. Discussion Metamizole is commonly used in paediatric inpatients in Germany. Serious ADRs occur but rarely. Continuous monitoring of drug therapy through, for example, stimulated reporting systems ensures that serious ADRs are detected, and appropriate interventions can be introduced.

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Fatal Agranulocytosis and Fournier’s Gangrene due to the Use of Metamizole

Cited by 6 publications

References 3 publications

One hundred years of dipyrone (metamizole): the recent evidence on its safety

One hundred years of dipyrone (metamizole): the recent evidence on its safety

Grundzüge des perioperativen Schmerzmanagements bei Säuglingen, Kindern und Jugendlichen

Metamizole Use in Children: Analysis of Drug Utilisation and Adverse Drug Reactions at a German University Hospital between 2015 and 2020

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