title: Nonchemotherapy drug-induced neutropenia and agranulocytosis: could medications be the culprit?
abstract: Drug-induced agranulocytosis is a severe complication that has been implicated with most classes of medications. Medications such as clozapine, trimethoprim-sulfamethoxazole and methimazole have been more commonly associated with agranulocytosis than other agents. Although the pathogenesis isn't fully elucidated, it appears to be two-fold with a direct toxicity to the myeloid cell line and immune-mediated destruction. Patients may be asymptomatic at the time neutropenia is discovered or may present with more severe complications such as sepsis. In approximately 5% of cases drug-induced agranulocytosis may be fatal. Management of drug-induced agranulocytosis includes the immediate discontinuation of the offending medication, initiation of broad-spectrum antibiotics and consideration of the use of granulocyte colony-stimulating factors in high-risk patients.
authors.affiliation: School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, NE, USA apick@creighton.edu.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Pick
authors.affiliation: School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, NE, USA.
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Nystrom
mesh_terms: D000380:Agranulocytosis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects; D013956:Antithyroid Agents / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000503:physiopathology*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D022423:Myeloid Cells / Q000187:drug effects; D009503:Neutropenia / Q000139:chemically induced; D011619:Psychotropic Drugs / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D013956:Antithyroid Agents; D011619:Psychotropic Drugs; D016179:Granulocyte Colony-Stimulating Factor
keywords: agranulocytosis; drug induced; neutropenia; nonchemotherapy