Non-chemotherapy drug-induced agranulocytosis in a tertiary hospital

Hum Exp Toxicol. 2016 Mar;35(3):244-50. doi: 10.1177/0960327115580603. Epub 2015 Apr 5.

Abstract

Drug-induced agranulocytosis is a rare haematological disorder considered as severe adverse drug reaction. Due to its low incidence, the number of studies are low and the variability of clinical features and presentation in hospitalized patients is rarely described. Awe performed an observational, transversal and retrospective study in the haematology and toxicology unit in a tertiary hospital located in Spain (Valencia) (1996-2010) in order to assess its incidence, the drugs involved, the management and outcomes of drug-induced agranulocytosis. Twenty-one cases of agranulocytosis were retrieved. All of them presented severe and symptomatic agranulocytosis (fever and infection). The most common drug associated with drug-induced agranulocytosis was metamizole administration but other drugs belonging to different pharmacological classes as well (carbimazol, sulfasalazine, bisoprolol, itraconazole, amitryptiline, ketorolac and claritomicine+cefuroxime). No differences between sex and age were found in relationship with the manifestations or course of agranulocytosis. In contrast, a significantly negative association was found between age of patients and the percentage of increase in neutrophil count. Administration of human granulocyte colony-stimulating factor did not significantly enhance the recovery of the process or the restoration of leucocytes count, suggesting a limited utility in this type of agranulocytosis.

Keywords: Agranulocytosis; bisoprolol; colony granulocytes-stimulating factor; drug-induced adverse reaction; itraconazole.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Agranulocytosis / chemically induced*
  • Agranulocytosis / drug therapy
  • Agranulocytosis / epidemiology*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Incidence
  • Leukocyte Count
  • Male
  • Middle Aged
  • Spain / epidemiology
  • Tertiary Care Centers / statistics & numerical data

Substances

  • Granulocyte Colony-Stimulating Factor