2020
DOI: 10.3390/jcm9061808
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Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients

Abstract: Agranulocytosis is a rare, but serious and life-threatening hematologic disorder in elderly patients. Idiosyncratic drug-induced agranulocytosis (IDIA) has been classically defined by a neutrophil count below 0.5 × 109/L. The annual incidence of IDIA in Europe is about 1.6–9.2 cases per million inhabitants. Increasing age and female sex have been considered as risk factors for the development of this condition. Besides, it is well known that older people take on average more drugs than younger people. This con… Show more

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Cited by 18 publications
(9 citation statements)
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“…Conversely, in the four retained cases of agranulocytosis with C/T, the limited presence of concomitant risk factors together with causality assessment suggests a true safety issue. Although currently no case reports or preclinical evidence of ceftolozane-induced agranulocytosis exist, the immune-mediated hypothesis may reasonably explain the occurrence of this unexpected AE with C/T, as reported for other agents, including beta-lactams [ 13 , 14 ]. However, a dose-dependent direct toxic effect on granulocytopoiesis cannot be excluded [ 15 ].…”
Section: Discussionmentioning
confidence: 91%
See 1 more Smart Citation
“…Conversely, in the four retained cases of agranulocytosis with C/T, the limited presence of concomitant risk factors together with causality assessment suggests a true safety issue. Although currently no case reports or preclinical evidence of ceftolozane-induced agranulocytosis exist, the immune-mediated hypothesis may reasonably explain the occurrence of this unexpected AE with C/T, as reported for other agents, including beta-lactams [ 13 , 14 ]. However, a dose-dependent direct toxic effect on granulocytopoiesis cannot be excluded [ 15 ].…”
Section: Discussionmentioning
confidence: 91%
“…However, a dose-dependent direct toxic effect on granulocytopoiesis cannot be excluded [ 15 ]. Additionally, elderly and female gender are recognized risk factors for drug-induced agranulocytosis [ 13 ]. Notably, mean age of our cases was approximately 77 years with female preponderance (75.0%).…”
Section: Discussionmentioning
confidence: 99%
“…There is approximately 5% of mortalities associated with idiosyncratic drug-induced neutropenia[ 19 ]. Poor prognosis is associated with individuals aged ≥ 65 years, absolute neutrophil count < 0.1 × 10 9 cells/L, severe infection, and comorbidities[ 20 ]. At present, the mechanism of PM-induced granulocytopenia is unknown, which is speculated to be related to idiosyncratic ADR.…”
Section: Discussionmentioning
confidence: 99%
“…282 ANCs below 0.5/nl are also typically referred to as agranulocytosis. 215 , 283 , 284 However, strictly speaking agranulocytosis requires near absence of neutrophils, that is, ANCs below 0.1/nl. 283 , 285 The clinical syndrome of agranulocytosis is commonly associated with a triad of symptoms encompassing fever, mouth ulcers, and sore throat.…”
Section: Side Effects Of Clozapinementioning
confidence: 99%