Amodiaquine-induced agranulocytosis: report of a case with in vitro studies of granulocyte-macrophage progenitor cells.
We report a case of amodiaquine-induced agranulocytosis in a 60-year-old woman. Four months after the agranulocytosis episode we investigated the effect of the drug using in vitro agar culture techniques. Amodiaquine at increasing concentrations (0.005, 0.05 and 0.5 microgram/ml) displayed an inhibitory effect, probably dose-dependent, on the growth of the patient's bone marrow GM-CFU colonies in the absence of autologous serum. In contrast, no effect was found on the colony and cluster growth of bone marrow samples from 13 healthy controls. Though it has been shown in several cases that amodiaquine-induced agranulocytosis occurs via immune-mediated mechanisms, our data are in support of a direct toxic effect of the drug on abnormally sensitive myeloid progenitor cells.
Aymard
J P
JP
Regional Blood Transfusion and Haematology Centre, Nancy, France.
Rouveix
B
B
Ferry
R
R
Janot
C
C
May
T
T
Legras
B
B
Streiff
F
F
D000380:Agranulocytosis / Q000139:chemically induced* / Q000473:pathology; D000655:Amodiaquine / Q000009:adverse effects*; D001853:Bone Marrow / Q000187:drug effects* / Q000473:pathology; D002455:Cell Division / Q000187:drug effects; D003114:Colony-Forming Units Assay; D005260:Female; D006098:Granulocytes / Q000187:drug effects / Q000473:pathology; D006412:Hematopoietic Stem Cells / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D008264:Macrophages / Q000187:drug effects / Q000473:pathology; D008875:Middle Aged
D000655:Amodiaquine