title: Life-threatening idiosyncratic drug-induced agranulocytosis in elderly patients.
abstract: Agranulocytosis is a life-threatening disorder in any age, but particularly so in elderly patients who are receiving, on average, a larger number of drugs than younger patients. Drug-induced agranulocytosis still remains a rare event, with an annual incidence rate of approximately 3-12 cases per million population. This disorder frequently occurs as an adverse reaction to drugs, particularly antibacterials, antiplatelet agents, antithyroid drugs, antipsychotics or antiepileptic drugs, and NSAIDs. Although patients experiencing drug-induced agranulocytosis may initially be asymptomatic, the severity of the neutropenia usually translates into the onset of severe sepsis that requires intravenous broad-spectrum antibacterial therapy. In this setting, haematopoietic growth factors have been shown to shorten the duration of neutropenia. Thus, with appropriate management, the mortality rate of idiosyncratic drug-induced agranulocytosis is now 5-10%. However, given the increased life expectancy and subsequent longer exposure to drugs, as well as the development of new agents, physicians should be aware of this complication and its management.
authors.affiliation: Department of Internal Medicine, Hôpitaux Universitaires of Strasbourg, Strasbourg, France. emmanuel.andres@chru-strasbourg.fr
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Andrès
authors.forename: Esther
authors.initials: E
authors.lastname: Noel
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: Kurtz
authors.forename: Nourredine
authors.initials: N
authors.lastname: Henoun Loukili
authors.forename: Georges
authors.initials: G
authors.lastname: Kaltenbach
authors.forename: Frédéric
authors.initials: F
authors.lastname: Maloisel
mesh_terms: D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D013956:Antithyroid Agents / Q000009:adverse effects; D003937:Diagnosis, Differential; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000970:Antineoplastic Agents; D014150:Antipsychotic Agents; D013956:Antithyroid Agents; D010975:Platelet Aggregation Inhibitors