title: Agranulocytosis and liver damage associated with pyrazinobutazone with evidence for an immunological mechanism.
abstract: Agranulocytosis and liver injury is described in a patient with Reiter's syndrome of 3 years duration who received pyrazinobutazone for 6 weeks before the development of the clinical picture reported. Other causes of agranulocytosis and hepatic damage were excluded and a lymphocyte transformation test to the drug revealed significant lymphocyte proliferation in response to the drug. This suggests a hypersensitivity reaction as the mechanism for this previously unrecognized association of adverse effects to pyrazinobutazone.
authors.affiliation: Faculty of Medicine, University Hospital of Santa Maria, Lisbon, Portugal.
authors.forename: V A
authors.initials: VA
authors.lastname: Maria
authors.forename: J A
authors.initials: JA
authors.lastname: da Silva
authors.forename: R M
authors.initials: RM
authors.lastname: Victorino
mesh_terms: D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000188:drug therapy; D004342:Drug Hypersensitivity / Q000209:etiology; D006529:Hepatomegaly / Q000139:chemically induced*; D006801:Humans; D008213:Lymphocyte Activation / Q000187:drug effects*; D008297:Male; D010653:Phenylbutazone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; C100279:pyrazinobutazone; D010653:Phenylbutazone