Journal
EXPERT REVIEW OF HEMATOLOGY
Volume 4, Issue 2, Pages 143-151Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/EHM.11.12
Keywords
agranulocytosis; hematopoietic growth factor; idiosyncratic drug-induced agranulocytosis; infections; neutropenia
Categories
Funding
- Chugai
- Amgen
- Roche
- GlaxoSmithKline
- Bristol-Myers Squibb
- Novartis
- TKT 5S
- Ferring and Effik
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Objective: In this article, we report and discuss the clinical presentation and management of idiosyncratic drug-induced agranulocytosis (neutrophil count <0.5 x 10(9)/l). Results/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 x 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 agranulocutosis is currently approximately 5%.
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