title: [Fatal agranulocytosis after metamizole reexposure].
abstract: We present the case of a 63 year old man who died of severe septic shock in the setting of agranulocytosis induced by dipyrone (metamizole). The patient had previously developed agranulocytosis after dipyrone exposure 18 months prior to this. The case illustrates the seriousness of dipyrone-induced agranulocytosis, highlights the risks associated with re-exposure and underlines the need for excellent communication between treating physicians and their patients. The possible underlying mechanisms, epidemiology and management of dipyrone-induced agranulocytosis are discussed.
authors.affiliation: Klinik für Intensivmedizin, Universitätsspital Basel.
authors.forename: Evmarie
authors.initials: E
authors.lastname: Zeiner
authors.affiliation: Klinik für Pharmakologie & Toxikologie und Regionales Pharmakovigilanzzentrum, Universitätsspital Basel.
authors.forename: Lea S
authors.initials: LS
authors.lastname: Blaser
authors.affiliation: Klinik für Intensivmedizin, Universitätsspital Basel.
authors.forename: Kai
authors.initials: K
authors.lastname: Tisljar
authors.affiliation: Klinik für Hämatologie, Universitätsspital Basel.
authors.forename: Dominik
authors.initials: D
authors.lastname: Heim
authors.affiliation: Klinik für Pharmakologie & Toxikologie und Regionales Pharmakovigilanzzentrum, Universitätsspital Basel.
authors.forename: Anne
authors.initials: A
authors.lastname: Taegtmeyer
mesh_terms: D000380:Agranulocytosis / Q000139:chemically induced* / Q000175:diagnosis; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000633:toxicity*; D004177:Dipyrone / Q000008:administration & dosage / Q000633:toxicity*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000139:chemically induced / Q000175:diagnosis; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000175:diagnosis; D011115:Polyneuropathies / Q000188:drug therapy*; D012008:Recurrence; D019233:Retreatment; D012772:Shock, Septic / Q000139:chemically induced* / Q000175:diagnosis; D013290:Streptococcal Infections / Q000139:chemically induced* / Q000175:diagnosis; D013297:Streptococcus pyogenes
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004177:Dipyrone
keywords: Agranulozytose; Metamizol; Septischer Schock; agranulozytosis; metamizole; septic shock