Immune basis for cimetidine-induced pancytopenia.
We report a case of a female patient with chronic myelogenous leukemia who presented, 8 yr after initial diagnosis, with pancytopenia, encephalopathy, and myalgia. The tentative diagnosis was accelerated phase of chronic myelogenous leukemia. However, because the patient had been treated with cimetidine for 7 months we first omitted this drug. When cimetidine was stopped, bone marrow recovered, and myalgia and encephalopathy subsided. Immunological studies showed stimulation of the patient's lymphocyte blastogenesis by cimetidine and a marked increase in the proportion of cytotoxic/suppressor T lymphocytes after incubation of peripheral blood lymphocytes with cimetidine for 6 days. These findings indicate a role for cell-mediated immunity in the pathogenesis of cimetidine-induced pancytopenia in this patient.
Nagler
A
A
Rozenbaum
H
H
Enat
R
R
Tatarsky
I
I
Katz
R
R
Pollack
S
S
D000368:Aged; D002927:Cimetidine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000473:pathology; D008214:Lymphocytes / Q000187:drug effects* / Q000276:immunology; D010198:Pancytopenia / Q000139:chemically induced* / Q000276:immunology
D002927:Cimetidine