Incidence, etiology and bone marrow characteristics of non-chemotherapy-induced agranulocytosis.
OBJECTIVE
Agranulocytosis is a rare but fatal condition. The majority of cases are associated with drugs. However, in-patient incidences and the relationship between clinical outcomes and bone marrow characteristics have not been established.


METHODS
We conducted a retrospective study in a university hospital. A total of 38 in-patients diagnosed with agranulocytosis were analyzed.


RESULTS
The average incidence of agranulocytosis in Songklanagarind Hospital between 1993 and 2007 was 0·98 cases per 10 000 admissions per year. Antimicrobial agents were the most common etiology (63% of patients) and antithyroid agents were the second most common (13·6%). Two patterns of bone marrow were noted: type I was characterized by a left-shifted granulopoiesis and type II was recognized as having hypocellular bone marrow with markedly reduced granulocyte precursors. A significantly higher mortality was associated with type II.


CONCLUSIONS
Antimicrobial agents are the most common cause and the rare granulocyte precursors in bone marrow are associated with higher mortality rates.
Department of Medicine, Faculty of Medicine, Prince of Songkla University, Kanchanavanich Road, Hat Yai, Thailand.
Benjawan
B
Apinantriyo
Arnuparp
A
Lekhakula
Pairaya
P
Rujirojindakul
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000380:Agranulocytosis / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology*; D000890:Anti-Infective Agents / Q000009:adverse effects; D013956:Antithyroid Agents / Q000009:adverse effects; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
D000890:Anti-Infective Agents; D013956:Antithyroid Agents