Clinical presentation and management of drug-induced agranulocytosis

Emmanuel Andrès*, Jacques Zimmer, Mustapha Mecili, Thierry Weitten, Martine Alt, Frédéric Maloisel

*Corresponding author for this work

    Research output: Contribution to journalArticleResearchpeer-review

    45 Citations (Scopus)

    Abstract

    Objective: In this article, we report and discuss the clinical presentation and management of idiosyncratic drug-induced agranulocytosis (neutrophil count <0.5 × 109/l). Results/conclusions: Idiosyncratic drug-induced agranulocytosis remains a potentially serious adverse event owing to the frequency of severe sepsis with severe deep tissue infections (e.g., pneumonia), septicemia and septic shock in approximately two-thirds of all hospitalized patients. However, several prognostic factors have recently been identified that may be helpful in practice to identify 'susceptible' patients. Old age (>65 years), septicemia or shock, metabolic disorders such as renal failure and a neutrophil count below 0.1 × 109/l are currently consensually accepted as poor prognostic factors. In this potentially life-threatening disorder, modern management with broad-spectrum antibiotics and hematopoietic growth factors (particularly granulocyte colony-stimulating factor) is likely to improve prognosis. Thus, with appropriate management, the mortality rate from idiosyncratic drug-induced agranulocutosis is currently approximately 5%.

    Original languageEnglish
    Pages (from-to)143-151
    Number of pages9
    JournalExpert Review of Hematology
    Volume4
    Issue number2
    DOIs
    Publication statusPublished - Apr 2011

    Keywords

    • agranulocytosis
    • hematopoietic growth factor
    • idiosyncratic drug-induced agranulocytosis
    • infections
    • neutropenia

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