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Agranulocytosis

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https://www.readbyqxmd.com/read/29298994/cost-effectiveness-of-hla-dqb1-hla-b-pharmacogenetic-guided-treatment-and-blood-monitoring-in-us-patients-taking-clozapine
#1
François R Girardin, Antoine Poncet, Arnaud Perrier, Nathalie Vernaz, Mark Pletscher, Caroline F Samer, Jeffrey A Lieberman, Jean Villard
Less than 1% of adult patients with schizophrenia taking clozapine develop agranulocytosis, and most of these cases occur within the first weeks of treatment. The human leukocyte antigen (HLA) region has been associated with genetic susceptibility to clozapine-induced agranulocytosis (single amino acid changes in HLA-DQB1 (126Q) and HLA-B (158T)). The current study aimed to evaluate the cost-effectiveness, from a healthcare provider's perspective, of an HLA genotype-guided approach in patients with treatment-resistant schizophrenia who were taking clozapine and to compare the results with the current absolute neutrophil count monitoring (ANCM) schemes used in the USA...
January 3, 2018: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/29296025/genome-wide-common-and-rare-variant-analysis-provides-novel-insights-into-clozapine-associated-neutropenia
#2
S E Legge, M L Hamshere, S Ripke, A F Pardinas, J I Goldstein, E Rees, A L Richards, G Leonenko, L F Jorskog, K D Chambert, D A Collier, G Genovese, I Giegling, P Holmans, A Jonasdottir, G Kirov, S A McCarroll, J H MacCabe, K Mantripragada, J L Moran, B M Neale, H Stefansson, D Rujescu, M J Daly, P F Sullivan, M J Owen, M C O'Donovan, J T R Walters
This corrects the article DOI: 10.1038/mp.2016.97.
January 2018: Molecular Psychiatry
https://www.readbyqxmd.com/read/29285884/two-year-observational-study-of-deferiprone-in-superficial-siderosis
#3
Remi A Kessler, Xu Li, Kateryna Schwartz, Hwa Huang, Maureen A Mealy, Michael Levy
INTRODUCTION: Superficial siderosis is a rare, neurodegenerative disease caused by toxic accumulation of hemosiderin on the surface of the brain and the spinal cord, most commonly from chronic subarachnoid hemorrhage. AIMS: The aim of this study was to assess the clinical and radiological outcomes of superficial siderosis patients using deferiprone, a cell permeant iron chelator. Subjects obtained pre- and post-treatment brain MRIs and weekly laboratory tests. Osirix software was used to develop a method of quantifying hemosiderin deposition...
December 28, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29281794/reduction-and-scavenging-of-chemically-reactive-drug-metabolites-by-nad-p-h-quinone-oxidoreductase-1-and-nrh-quinone-oxidoreductase-2-and-variability-in-hepatic-concentrations
#4
Shalenie P den Braver-Sewradj, Michiel W den Braver, Robin M Toorneman, Stephanie van Leeuwen, Yongjie Zhang, Stefan J Dekker, Nico P E Vermeulen, Jan N M Commandeur, J Chris Vos
Detoxicating enzymes NAD(P)H:quinone oxidoreductase 1 (NQO1) and NRH:quinone oxidoreductase 2 (NQO2) catalyze the two-electron reduction of quinone-like compounds. The protective role of the polymorphic NQO1 and NQO2 enzymes is especially of interest in the liver as the major site of drug bioactivation to chemically reactive drug metabolites. In the current study, we quantified the concentrations of NQO1 and NQO2 in 20 human liver donors and NQO1 and NQO2 activities with quinone-like drug metabolites. Hepatic NQO1 concentrations ranged from 8 to 213 nM...
December 27, 2017: Chemical Research in Toxicology
https://www.readbyqxmd.com/read/29230675/clozapine-and-gastrointestinal-hypomotility
#5
REVIEW
Dan Cohen
Gastrointestinal hypomotility (GIH) is an under-reported but highly prevalent and potentially dangerous side effect of clozapine. In a comprehensive meta-analysis of clozapine-treated patients, the prevalence of GIH was 32%. In general, GIH has consistently been reported to have a negative impact on quality of life, and there is no reason to believe this will be different in clozapine-treated patients with therapy-resistant schizophrenia. GIH is dangerous; in a comparative review of lethal side effects of clozapine, the mortality of agranulocytosis was 2...
December 11, 2017: CNS Drugs
https://www.readbyqxmd.com/read/29224313/-incidence-of-blood-stream-infections-of-1265-patients-with-hematopoietic-stem-cell-transplantation-and-analysis-of-pathogenic-bacteria
#6
Q Z Han, Y Chen, H Yang, X F Zhang, J Chen, D P Wu, S N Chen, H Y Qiu
Objective: To analyze the incidence and microbiological features of blood stream infections (BSI) of patients with hematopoietic stem cell transplantation (HSCT) and to provide laboratory data for empirical use of antibiotic for the HSCT patients with BSI. Methods: The incidence of bloodstream infection, the positive rate of blood culture, bacterial spectrum and drug resistance were analyzed in 1 265 HSCT recipients during 2013 and 2015 were retrospectively studied. Results: Of 1265 patients undergoing HSCT, 1 422 cases of suspected BSI occurred in 784 patients (61...
November 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29222255/non-chemotherapy-drug-induced-neutropenia-key-points-to-manage-the-challenges
#7
REVIEW
Brian R Curtis
Non-chemotherapy idiosyncratic drug-induced neutropenia (IDIN) is a relatively rare but potentially fatal disorder that occurs in susceptible individuals, with an incidence of 2.4 to 15.4 cases per million population. Affected patients typically experience severe neutropenia within several weeks to several months after first exposure to a drug, and mortality is ∼5%. The drugs most frequently associated with IDIN include metamizole, clozapine, sulfasalazine, thiamazole, carbimazole, amoxicillin, cotrimoxazole, ticlopidine, and valganciclovir...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29211697/cocaine-levamisole-associated-autoimmune-syndrome-a-disease-of-neutrophil-mediated-autoimmunity
#8
Michael J Cascio, Kuang-Yu Jen
PURPOSE OF REVIEW: Levamisole was previously used for its immunomodulatory properties to treat rheumatoid arthritis and some cancers. However, because of serious side-effects, it was taken off the market in the United States. Recently, levamisole has reemerged as a popular cocaine adulterant. Some individuals who consume levamisole-adulterated cocaine can develop a life-threatening autoimmune syndrome. In this review, the medical consequences of levamisole exposure and postulated mechanisms by which levamisole induces these adverse effects are discussed...
January 2018: Current Opinion in Hematology
https://www.readbyqxmd.com/read/29203051/thiamazole-induced-agranulocytosis-leading-to-abscessus-pneumonia-rare-but-challenging
#9
Biljana Lazovic, Vuk Andrejevic, Aleksandar Ivanovic, Vladimir Zugic
No abstract text is available yet for this article.
December 1, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29200896/methamphetamine-use-with-subsequent-thyrotoxicosis-thyroid-storm-agranulocytosis-and-modified-total-thyroidectomy-a-case-report
#10
Omar Viswanath, Deanna C Menapace, Don B Headley
Thyroid storm is a rare, potentially lethal condition involving collapse of the hypothalamic-pituitary-thyroid feedback loop. Thyroid storm carries a significant mortality rate, thus requiring prompt identification and treatment. A 47-year-old woman presented to the emergency department complaining of palpitations, shortness of breath, and emesis for 24 hours after using methamphetamine. Past medical history was significant for untreated hyperthyroidism. Physical examination revealed a prominent, palpable thyroid...
2017: Clinical Medicine Insights. Ear, Nose and Throat
https://www.readbyqxmd.com/read/29181135/graves-disease-thyrotoxicosis-and-propylthiouracil-related-agranulocytosis-successfully-treated-with-therapeutic-plasma-exchange-and-g-csf-followed-by-total-thyroidectomy
#11
Anna Candoni, Federico De Marchi, Fabio Vescini, Sara Mauro, Cristina Rinaldi, Marco Piemonte, Nicholas Rabassi, Maria Vittoria Dubbini, Renato Fanin
Antithyroid drugs can be a rare cause of agranulocytosis (0.5% of treated patients). Suspension of these drugs is mandatory in these patients and may result in worsening hyperthyroidism. We report the case of a 27-year-old woman who is 3 months post-partum, breastfeeding, and suffering with Graves' disease hyperthyroidism treated first with methimazole and then with propylthiouracil due to a methimazole allergy. She was admitted for urosepsis and agranulocytosis. The patient was diagnosed with propylthiouracil related agranulocytosis, diffuse toxic goiter and thyro-gastric syndrome...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29145679/-leukopenia-a-diagnostic-guideline-for-the-clinical-routine
#12
Deborah Christen, Tim H Brümmendorf, Jens Panse
Reasons for leukopenia can be numerous. To get close to the diagnosis it's always useful to check previous blood counts of the patient to get a feeling for the dynamic development of the leukopenia. Furthermore, it's important to check the red blood cell count and platelet count as well; a bi- or a pancytopenia usually implies an insufficient production in the bone marrow. Nevertheless, a manual counted peripheral blood smear is an essential step towards the right diagnosis in leukopenia: Beside cell counts of the single subgroups of leucocytes it also provides information on potential causes such as dysplasia...
November 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29107664/eruption-of-lymphocyte-recovery-with-atypical-lymphocytes-mimicking-a-primary-cutaneous-t-cell-lymphoma-a-series-of-12-patients
#13
Charlotte Hurabielle, Emilie Sbidian, Helmut Beltraminelli, Brigitte Bouchindhomme, Catherine Chassagne-Clément, Brigitte Balme, Céline Bossard, Marie-Hélène Delfau-Larue, Pierre Wolkenstein, Olivier Chosidow, Catherine Cordonnier, Andrea Toma, Cécile Pautas, Nicolas Ortonne
Eruption of lymphocyte recovery (ELR) may occur during bone marrow aplasia after chemotherapies. We reviewed the clinical and pathologic features of 12 patients (male/female: 7/5, median age: 61years) with an atypical ELR histologically mimicking a primary cutaneous T-cell lymphoma (CTCL) such as Sézary Syndrome or CD30+ T-cell lymphoproliferative disorder (LPD). All the patients displayed an erythematous maculopapular eruption on the trunk and the limbs, associated with fever. All but one had received a polychemotherapy for an acute myeloid leukemia (n=10) or an urothelial carcinoma (n=1) before the occurrence of the skin eruption...
October 28, 2017: Human Pathology
https://www.readbyqxmd.com/read/29092658/an-unexpected-circumstance-acute-dystonic-reaction-in-the-setting-of-clozapine-administration
#14
Alexander Morris Kaplan, William Bradly Pitts, Iqbal Ahmed
Clozapine is a second-generation antipsychotic typically reserved for refractory psychotic disorders due to its high-risk side effect profile to include agranulocytosis, with its attendant need for regular blood draws. While reports of extrapyramidal symptoms (EPS), including acute dystonic reactions, are exceedingly rare, we present the case of a 44-year-old male with a long-standing history of treatment-resistant schizoaffective disorder and no history of EPS who experienced an acute buccal dystonic reaction in the setting of clozapine initiation and discontinuation of depot and oral risperidone...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29073755/neutropenia-with-multiple-antipsychotics-including-dose-dependent-neutropenia-with-lurasidone
#15
Shabnam Sood
Antipsychotic-induced agranulocytosis is a significant side effect that is known to occur with most of the antipsychotic medications. It usually resolves once the medications are stopped and patients are able to be switched over to another antipsychotic medication. Lurasidone has not been reported to cause leukopenia and neutropenia. This case report is of a patient with a past history of risperidone induced-aganulocytosis developing dose related leukopenia and neutropenia with lurasidone.
November 30, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29040154/clozapine-associated-neutropenia-and-agranulocytosis
#16
Emmanuel Andres, Rachel Mourot-Cottet
No abstract text is available yet for this article.
December 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29026576/use-of-granulocyte-colony-stimulating-factor-in-the-treatment-of-methimazole-induced-agranulocytosis-a-case-report
#17
Asha Birmingham, Carissa Mancuso, Craig Williams
A comparison of this case to previously published reports suggests that granulocyte colony-stimulating factor may be associated with improved prognosis in severe antithyroid drug-induced neutropenia, and that weight-based doses could be an appropriate strategy.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29024184/the-use-of-dipyrone-metamizol-as-an-analgesic-in-children-what-is-the-evidence-a-review
#18
REVIEW
Thomas G de Leeuw, Maaike Dirckx, Antonia Gonzalez Candel, Gail P Scoones, Frank J P M Huygen, Saskia N de Wildt
Dipyrone has analgesic, spasmolytic, and antipyretic effects and is used to treat pain. Due to a possible risk of agranulocytosis with the use of dipyrone, it has been banned in a number of countries. The most commonly used data for the use of dipyrone are related to adults. Information relating to the use of dipyrone in children is scarce. Given the potential added value of dipyrone in the treatment of pain, a review of the literature was conducted to obtain more insight into the analgesic efficacy of dipyrone in children as well as the safety of dipyrone in terms of adverse events...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28988934/bis-choline-tetrathiomolybdate-in-patients-with-wilson-s-disease-an-open-label-multicentre-phase-2-study
#19
Karl Heinz Weiss, Frederick K Askari, Anna Czlonkowska, Peter Ferenci, Jeff M Bronstein, Danny Bega, Aftab Ala, David Nicholl, Susan Flint, Lars Olsson, Thomas Plitz, Carl Bjartmar, Michael L Schilsky
BACKGROUND: Wilson's disease is a genetic disorder in which copper accumulates in the liver, brain, and other tissues. Therapies are limited by efficacy, safety concerns, and multiple daily dosing. Bis-choline tetrathiomolybdate (WTX101) is an oral first-in-class copper-protein-binding molecule that targets hepatic intracellular copper and reduces plasma non-ceruloplasmin-bound copper (NCC) by forming tripartite complexes with albumin and increasing biliary copper excretion. We aimed to assess the efficacy and safety of WTX101 in the initial or early treatment of patients with Wilson's disease...
October 5, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28984748/clozapine-induced-agranulocytosis-granulocytopenia-mechanisms-and-monitoring
#20
Michał Wiciński, Mateusz M Węclewicz
PURPOSE OF REVIEW: Clozapine-induced agranulocytosis/granulocytopenia (CIAG) is an uncommon condition, but potentially fatal in consequences. The pathogenesis, despite multiple experiments, is not fully elucidated. The current theory suggests reactive oxygen species - nitrenium ion as the most important factor of CIAG. In this review, mechanism and monitoring of CIAG will be discussed. RECENT FINDINGS: The mechanism of CIAG seems to have an autoimmune background, rather than toxic...
October 4, 2017: Current Opinion in Hematology
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