title: Non-chemotherapy drug-induced agranulocytosis in a tertiary hospital.
abstract: Drug-induced agranulocytosis is a rare haematological disorder considered as severe adverse drug reaction. Due to its low incidence, the number of studies are low and the variability of clinical features and presentation in hospitalized patients is rarely described. Awe performed an observational, transversal and retrospective study in the haematology and toxicology unit in a tertiary hospital located in Spain (Valencia) (1996-2010) in order to assess its incidence, the drugs involved, the management and outcomes of drug-induced agranulocytosis. Twenty-one cases of agranulocytosis were retrieved. All of them presented severe and symptomatic agranulocytosis (fever and infection). The most common drug associated with drug-induced agranulocytosis was metamizole administration but other drugs belonging to different pharmacological classes as well (carbimazol, sulfasalazine, bisoprolol, itraconazole, amitryptiline, ketorolac and claritomicine+cefuroxime). No differences between sex and age were found in relationship with the manifestations or course of agranulocytosis. In contrast, a significantly negative association was found between age of patients and the percentage of increase in neutrophil count. Administration of human granulocyte colony-stimulating factor did not significantly enhance the recovery of the process or the restoration of leucocytes count, suggesting a limited utility in this type of agranulocytosis.
authors.affiliation: Department of Nursing, University of Valencia, Valencia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Navarro-Martínez
authors.affiliation: Department of Nursing, University of Valencia, Valencia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Chover-Sierra
authors.affiliation: Department of Nursing, University of Valencia, Valencia, Spain omar.cauli@uv.es.
authors.forename: O
authors.initials: O
authors.lastname: Cauli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000380:Agranulocytosis / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D016179:Granulocyte Colony-Stimulating Factor
keywords: Agranulocytosis; bisoprolol; colony granulocytes-stimulating factor; drug-induced adverse reaction; itraconazole