title: Clinical presentation and management of drug-induced agranulocytosis.
abstract: OBJECTIVE
  In this article, we report and discuss the clinical presentation and management of idiosyncratic drug-induced agranulocytosis (neutrophil count <0.5 × 10(9)/l).
  
  
  CONCLUSIONS
  Idiosyncratic drug-induced agranulocytosis remains a potentially serious adverse event owing to the frequency of severe sepsis with severe deep tissue infections (e.g., pneumonia), septicemia and septic shock in approximately two-thirds of all hospitalized patients. However, several prognostic factors have recently been identified that may be helpful in practice to identify 'susceptible' patients. Old age (>65 years), septicemia or shock, metabolic disorders such as renal failure and a neutrophil count below 0.1 × 10(9)/l are currently consensually accepted as poor prognostic factors. In this potentially life-threatening disorder, modern management with broad-spectrum antibiotics and hematopoietic growth factors (particularly granulocyte colony-stimulating factor) is likely to improve prognosis. Thus, with appropriate management, the mortality rate from idiosyncratic drug-induced agranulocytosis is currently approximately 5%.
authors.affiliation: Department of Internal Medicine B, University Hospital of Strasbourg, 1 Porte de l'Hôpital, Strasbourg Cedex, France. emmanuel.andres@chru-strasbourg.fr
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Andrès
authors.forename: Jacques
authors.initials: J
authors.lastname: Zimmer
authors.forename: Mustapha
authors.initials: M
authors.lastname: Mecili
authors.forename: Thierry
authors.initials: T
authors.lastname: Weitten
authors.forename: Martine
authors.initials: M
authors.lastname: Alt
authors.forename: Frédéric
authors.initials: F
authors.lastname: Maloisel
mesh_terms: D000367:Age Factors; D000380:Agranulocytosis / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D013956:Antithyroid Agents / Q000009:adverse effects; D003937:Diagnosis, Differential; D005343:Fibrinolytic Agents / Q000009:adverse effects; D016179:Granulocyte Colony-Stimulating Factor / Q000502:physiology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000502:physiology; D006801:Humans; D007958:Leukocyte Count; D009504:Neutrophils / Q000166:cytology / Q000276:immunology; D011014:Pneumonia / Q000150:complications; D051437:Renal Insufficiency / Q000150:complications; D012307:Risk Factors; D018805:Sepsis / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents; D013956:Antithyroid Agents; D005343:Fibrinolytic Agents; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor