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Agranulocytosis

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https://www.readbyqxmd.com/read/29145679/-leukopenia-a-diagnostic-guideline-for-the-clinical-routine
#1
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
#2
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
#3
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
#4
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
#5
Emmanuel Andres, Rachel Mourot-Cottet
No abstract text is available yet for this article.
October 16, 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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28954408/history-and-outcome-of-febrile-neutropenia-outside-the-oncology-setting-a-retrospective-study-of-76-cases-related-to-non-chemotherapy-drugs
#10
Emmanuel Andrès, Rachel Mourot-Cottet, Frédéric Maloisel, Olivier Keller, Thomas Vogel, François Séverac, Martine Tebacher, Jacques-Eric Gottenberg, Jean-Christophe Weber, Georges Kaltenbach, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht
BACKGROUND: Despite major advances in its prevention and treatment, febrile neutropenia remains a most concerning complication of cancer chemotherapy. Outside the oncology setting, however, only few data are currently available on febrile neutropenia related to non-chemotherapy drugs. We report here data on 76 patients with febrile neutropenia related to non-chemotherapy drugs, followed up in a referral center within a university hospital. PATIENTS AND METHODS: Data from 76 patients with idiosyncratic drug-induced febrile neutropenia were retrospectively reviewed...
September 26, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28948574/correlation-between-serum-concentrations-of-n-desmethylclozapine-and-granulocyte-levels-in-patients-with-schizophrenia-a-retrospective-observational-study
#11
Robert L Smith, Tore Haslemo, Ole A Andreassen, Erik Eliasson, Marja-Liisa Dahl, Olav Spigset, Espen Molden
BACKGROUND: Clozapine is restricted to use in patients with treatment-refractory schizophrenia due to the risk of a serious drop in absolute neutrophil granulocyte count (ANC). The formation of reactive, unstable metabolites (adducts) has been suggested as a mechanism of clozapine-induced granulocyte decline. These adducts are not detectable in vivo, but stable clozapine metabolites could potentially be indirect pharmacokinetic measures of adduct formation. OBJECTIVE: The present retrospective observational study investigated the correlation between concentrations of N-desmethylclozapine, the major stable clozapine metabolite, and ANC in a real-life population of clozapine-treated patients...
September 25, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28931918/association-of-hla-b-and-hla-drb1-polymorphisms-with-antithyroid-drug-induced-agranulocytosis-in-a-han-population-from-northern-china
#12
Yayi He, Jie Zheng, Qian Zhang, Peng Hou, Feng Zhu, Jian Yang, Wenhao Li, Pu Chen, Shu Liu, Bao Zhang, Bingyin Shi
Antithyroid drug (ATD)-induced agranulocytosis is associated with human leukocyte antigen (HLA) and nearby genes in Southeast Asian and European populations. The susceptibility of the Han population from northern China to ATD-induced agranulocytosis has not been reported. We evaluated the associations of genetic variants at the HLA-B and HLA-DRB1 loci and 32 candidate single nucleotide polymorphisms (SNPs) with agranulocytosis in 29 patients with ATD-induced agranulocytosis and in 140 patients with Graves' disease (GD) as controls...
September 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28924483/thyroidectomy-for-the-treatment-of-graves-thyrotoxicosis-in-thioamide-induced-agranulocytosis-and-sepsis
#13
Colin L Knight, Shamil D Cooray, Jaideep Kulkarni, Michael Borschmann, Mark Kotowicz
A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF) analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol's iodine), cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28913970/human-neutrophils-show-decreased-survival-upon-long-term-exposure-to-clozapine
#14
Aya Goto, Akira Yoshimi, Tomoko Nagai, Mako Ukigai, Akihiro Mouri, Norio Ozaki, Yukihiro Noda
OBJECTIVE: Clozapine is an atypical antipsychotic prescribed for treatment-resistant schizophrenic patients, but treatment with clozapine is strictly limited because it can induce lethal-hematologic side effects. We investigated the effects of short- and long-term exposure of human neutrophils derived from healthy subjects to clozapine and compared them with the effects of reactive metabolite of clozapine, olanzapine, and doxorubicin. METHODS: Neutrophils were exposed to clozapine and olanzapine (1, 10, 50, or 100 μM), reactive metabolite of clozapine (50 or 100 μM), or doxorubicin (0...
September 15, 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28882687/sodium-valproate-and-clozapine-induced-neutropenia-a-case-control-study-using-register-data
#15
Steffi Malik, John Lally, Olesya Ajnakina, Megan Pritchard, Amir Krivoy, Fiona Gaughran, Hitesh Shetty, Robert J Flanagan, James H MacCabe
BACKGROUND: The use of clozapine is limited due to the occurrence of neutropenia, and the rare but life threatening adverse event of agranulocytosis. There is little epidemiological research into clinical factors that may impact on this risk. We conducted a case control study examining the clinical risk factors for neutropenia patients treated with clozapine. METHOD: A case-control study was conducted within a database of anonymised electronic clinical records. All patients who discontinued clozapine due to a neutropenic event were included as cases...
September 4, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28880354/-pimavanserin-a-new-treatment-for-the-parkinson-s-disease-psychosis
#16
J H Duits, M S Ongering, H J M Martens, P F J Schulte
Clozapine is an effective drug for treating psychosis in Parkinson's disease (PDP) and is registered as such in the Netherlands. However, clozapine can have adverse effects, including agranulocytosis. The new drug pimavanserin was recently registered in the United States for the treatment of PDP.<br/> AIM: To review the literature on pimavanserin and discuss the position it currently occupies in the Netherlands as a potential treatment for PDP.<br/> METHOD: Systematic search of the literature.<br/> RESULTS: We found reports on four randomised controlled trials (RCTs), one review and six articles about the pharmacokinetics and pharmacodynamics of pimavanserin...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28879784/non-chemotherapy-drug-induced-neutropenia-an-update
#17
REVIEW
Emmanuel Andrès, Rachel Mourot-Cottet
To date, non-chemotherapy drug-induced severe neutropenia (neutrophil count of ≤0.5 x 10(9)/L) also called idiosyncratic drug-induced agranulocytosis is little discussed in the literature. In the present paper, we report and discuss the clinical data and management of this rare disorder. Areas covered: To do this, we carried out a review of the literature using PubMed database of the US National Library of Medicine. We also used data from the American Society of Hematology educational books, textbooks of Hematology and Internal medicine, and information gleaned from international meetings...
November 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28874654/agranulocytosis-induced-by-sinomenine-hydrochloride
#18
Juerong Chen, Bing Zhong, Yong Wang
BACKGROUND Sinomenine hydrochloride is an alkaloid that is extracted from the Chinese herbal plant Sinomenium acutum, and is used as a herbal medicine in the treatment or rheumatic disease. This report is the first to describe a case of sinomenine hydrochloride-induced agranulocytosis. CASE REPORT A 44-year-old woman with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) was treated with sinomenine hydrochloride and developed agranulocytosis with a neutrophil count of 0.01×10^9/L. She subsequently developed an opportunistic bacterial infection...
September 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28836551/clinical-characteristics-of-bloodstream-infections-in-pediatric-acute-leukemia-a-single-center-experience-with-231-patients
#19
Jia-Feng Yao, Nan Li, Jin Jiang
BACKGROUND: Acute leukemia is the most common pediatric hematological malignancy. Bloodstream infections (BSIs) are severe complications in these patients during chemotherapy. This study aimed to explore the clinical presentation and etiology of BSI, as well as the common sites of infection, and to provide a basis for the rational regarding antibiotic use. METHODS: We performed a retrospective chart review of all pediatric patients who had acute leukemia accompanied by a BSI in our hospital from December 2011 to September 2015...
September 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28835863/clozapine-induced-microseizures-orofacial-dyskinesia-and-speech-dysfluency-in-an-adolescent-with-treatment-resistant-early-onset-schizophrenia-on-concurrent-lithium-therapy
#20
Vivekananda Rachamallu, Ayman Haq, Michael M Song, Manish Aligeti
Clozapine is an atypical antipsychotic used in the treatment of refractory schizophrenia. It has a well-known side effect profile, including agranulocytosis, decreased seizure threshold, and tardive dyskinesia. In addition, numerous case reports have described clozapine-induced stuttering in adults. However, there has been only one previous case report describing it in the adolescent population. In addition, concurrent lithium therapy has been shown to enhance the neurotoxic effects of antipsychotics and lower the seizure threshold...
2017: Case Reports in Psychiatry
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