Population-Based Drug-Induced Agranulocytosis

Abstract

Agranulocytosis is rare but serious. A few drugs account for two thirds of the cases. Our results also provide reassurance regarding the risk associated with a number of newly marketed drugs.

A Confirmed Case of Agranulocytosis after Use of Cocaine Contaminated with Levamisole

“…Although it is not clear why only certain patients develop anti-granulocyte antibodies, rheumatoid arthritis and the presence of HLA-B27 antigens appear to confer increased risk [8,13]. Other isoantibodies, including c-ANCA, p-ANCA, anti-phospholipid, and IgM anti-cardiolipin antibodies, have also been reported in association with levamisole use [9]. In a recently published Canadian letter, all patients with levamisole-associated agranulocytosis had detectable lupus anticoagulant [10].…”

“…Agranulocytosis, a profound depletion of circulating neutrophils, is a rare but life-threatening condition. In one study, the incidence of agranulocytosis was five cases per million population per year, with a case-fatality rate of 9.1% [9]. Like any profoundly neutropenic patient, those with levamisole-associated agranulocytosis are susceptible to fulminant and opportunistic infections.…”

Normales Knochenmark und häufige reaktive Veränderungen

“…Folsäuremangels [12]. Clozapin, Metamizol oder Thiamazol; [18]), aplastischen Anämien, bei anderen Autoimmunerkrankungen [6] oder bei Zytomegalovirusprimärinfektionen [20] beobachtet (. Abb.…”

Meropenem-Induced Neutropenia in a Neonate

“…2, 3 Ibañez et al 4 conducted a case-control epidemiological surveillance study of 78.7 million cases to assess the incidence of drug-induced agranulocytosis. They identified 396 confirmed cases of agranulocytosis with an overall incidence of 5.02:1 million inhabitants per year.…”

“…The drugs most commonly attributed in this study were dipyrone (16%), beta-lactam antibiotics (12.01%), ticlopidine (11.1%), antithyroid drugs (7.21%), and sulfonamide antibiotics (5.44%). 4 Drug-induced neutropenia is a subclassification of agranulocytosis specific to neutrophils that has been associated with beta-lactam antibiotics. Meropenem is a carbapenem with broad-spectrum coverage of Gram-positive and Gram-negative aerobic and anaerobic microorganisms.…”