Neutropenia and cutaneous lesions secondary to propafenone.
We present a case of concomitant occurrence of two uncommon secondary effects of propafenone observed in the same patient. A 73-year-old woman presented with asthenia and erythematosus plaques on the trunk and extremities, 2 months after the association of propafenone to her usual medication. Our examination recognized an acute neutropenia with a predominance of immature cells on the bone marrow smear. Skin biopsy was compatible with a subacute cutaneous lupus erythematosus-like skin reaction (SCLE). After the suspension of all drugs there was a complete clinical and analytical recovery. Her medications were then sequentially introduced, with the exception of propafenone. After six months of follow-up the patient remained asymptomatic. In this case cutaneous lesions were the first symptoms related to propafenone. Although the resolution of cutaneous disease is usually easily achieved, it requires an extensive investigation to identify and manage the possibly lethal haematological side effects.
Couto
Nuno
N
Medicine Department, Hospital Geral de S. António, Largo Abel Salazar, 4099-001 Porto, Portugal. nuno.couto@gmail.com
Ferreira
Márcia
M
Reis
Ernestina
E
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001706:Biopsy; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000139:chemically induced*; D009503:Neutropenia / Q000139:chemically induced*; D011405:Propafenone / Q000009:adverse effects*
D000889:Anti-Arrhythmia Agents; D011405:Propafenone