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Agranulocytosis

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https://www.readbyqxmd.com/read/29786829/meta-analysis-examining-the-epidemiology-of-clozapine-associated-neutropenia
#1
N Myles, H Myles, S Xia, M Large, S Kisely, C Galletly, R Bird, D Siskind
BACKGROUND: Clozapine is associated with life-threatening neutropenia. There are no previous meta-analyses of the epidemiology of clozapine-associated neutropenia. OBJECTIVES: To determine the cumulative incidence of mild, moderate and severe neutropenia, incidence of death related to severe neutropenia, case fatality rate of neutropenia and the longitudinal incidence of neutropenia following exposure to clozapine. DATA SOURCES: A systematic search of Medline, EMBASE and PsycINFO using search terms [clozapine OR clopine OR zaponex OR clozaril] AND [neutropenia OR agranulocytosis]...
May 21, 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29772595/-case-report-metamizole-induced-agranulocytosis
#2
Falk A Gonnert, Winfried Meißner
Metamizole is primarily used for severe perioperative pain, acute injury and colic, and cancer pain. For other acute/chronic forms of pain and high fever, it should only be used if unresponsive to other agents. Metamizole should not be used for middle and low pain. Oral application should be preferred. A contraindication for metamizole is leukopenia. Clinical signs for agranulocytosis are fever, tonsillitis and aphthous stomatitis.
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29737522/interventions-for-improving-adherence-to-iron-chelation-therapy-in-people-with-sickle-cell-disease-or-thalassaemia
#3
REVIEW
Patricia M Fortin, Sheila A Fisher, Karen V Madgwick, Marialena Trivella, Sally Hopewell, Carolyn Doree, Lise J Estcourt
BACKGROUND: Regularly transfused people with sickle cell disease (SCD) and people with thalassaemia (who are transfusion-dependent or non-transfusion-dependent) are at risk of iron overload. Iron overload can lead to iron toxicity in vulnerable organs such as the heart, liver and endocrine glands; which can be prevented and treated with iron chelating agents. The intensive demands and uncomfortable side effects of therapy can have a negative impact on daily activities and well-being, which may affect adherence...
May 8, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29727586/efficacy-and-safety-of-iron-chelators-in-thalassemia-and-sickle-cell-disease-a-multiple-treatment-comparison-network-meta-analysis-and-trial-sequential-analysis
#4
Kannan Sridharan, Gowri Sivaramakrishnan
BACKGROUND: To compare the efficacy and safety of desferrioxamine (DFO), deferiprone (DFP), deferasirox (DFX) and silymarin in patients with either thalassemia or sickle cell disorder through network meta-analysis. METHODS: Electronic databases were searched for appropriate randomized clinical trials comparing iron chelators in patients with iron overload. Random effects model was used to generate direct, indirect and mixed treatment comparison pooled estimates for the following outcomes: serum ferritin, liver iron concentration (LIC), changes in serum ferritin, mortality, urine iron excretion, adverse events, neutropenia, agranulocytosis and number of patients withdrawing the chelating therapy...
May 4, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29669774/transient-immune-mediated-agranulocytosis-following-mycoplasma-pneumoniae-infection
#5
Luani Barge, Gail Pahn, Nicholas Weber
Mycoplasma pneumoniae is a common respiratory pathogen which may cause haematological manifestations including haemolytic anaemia and thrombocytopaenia. Severe neutropaenia is rare with very few cases reported in the literature. An 85-year-old man was transferred to our facility with agranulocytosis in the context of an infective exacerbation of chronic obstructive pulmonary disease with positive serological testing for M. pneumoniae. No alternative infective, autoimmune or lymphoproliferative cause of the neutropaenia was identified...
April 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29607229/a-case-of-levamisole-induced-agranulocytosis
#6
Thamer Kassim, Lakshmi Chintalacheruvu, Osman Bhatty, Mohammad Selim, Osama Diab, Ali Nayfeh, Jayadev Manikkam Umakanthan, Maryam Gbadamosi-Akindele
A sixty-eight-year-old male with a past medical history of recurrent cocaine use presented to the emergency department with recurrent diarrhea and was found to have a white blood cell (WBC) count of 1.9 × 109 /L with agranulocytosis (absolute neutrophil count (ANC) of 95 cell/mm3 ). At admission, the patient disclosed that he used cocaine earlier during the day, and a urine drug screen tested positive for this. On hospital day one, the patient was found to have a fever with a maximum temperature of 313...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29560017/severe-drug-induced-agranulocytosis-successfully-treated-with-recombinant-human-granulocyte-colony-stimulating-factor
#7
Yohei Kubota, Toh Yoon Ezekiel Wong
When elderly patients are prescribed many different medications, the risk for developing serious adverse events should be kept in mind. One of these adverse events is agranulocytosis, which, although rare, can be life-threatening if left untreated. The majority of agranulocytosis cases are caused by drugs, including antibiotics. Here, we report a case of severe agranulocytosis in a 96-year-old woman following antibiotic therapy which was successfully managed using recombinant human granulocyte colony-stimulating factor (rhG-CSF) and the appropriate choice of antibiotics to treat her concomitant infection...
2018: Case Reports in Medicine
https://www.readbyqxmd.com/read/29552362/severe-hyperthyroidism-complicated-by-agranulocytosis-treated-with-therapeutic-plasma-exchange-case-report-and-review-of-the-literature
#8
Vishnu Garla, Karthik Kovvuru, Shradha Ahuja, Venkatataman Palabindala, Bharat Malhotra, Sohail Abdul Salim
Aim: To present a case of Graves' disease complicated by methimazole induced agranulocytosis treated with therapeutic plasma exchange (TPE) and review of the literature. Case Presentation: A 21-year-old patient with a history of Graves' disease presented to the endocrine clinic. His history was significant for heat intolerance, weight loss, and tremors. Upon examination he had tachycardia, smooth goiter, thyroid bruit, and hyperactive reflexes. He was started on methimazole and metoprolol and thyroidectomy was to be done once his thyroid function tests normalized...
2018: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29548760/clozapine-induced-cardiomyopathy-and-myocarditis-monitoring-a-systematic-review
#9
Kristen N Knoph, Robert J Morgan, Brian A Palmer, Kathryn M Schak, Amanda C Owen, Megan R Leloux, Mayur Patel, Jonathan G Leung
The use of clozapine requires monitoring the absolute neutrophil count because of the risk of agranulocytosis, but other potentially fatal adverse events associated with clozapine (specifically, myocarditis and cardiomyopathy) do not have mandatory procedures. We performed a systematic review of English-language articles to synthesize an evidence-based approach for myocarditis and cardiomyopathy monitoring. Articles published from January 1988 through February 2017 were identified through a search of Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Web of Science, Scopus, and Google Scholar...
March 13, 2018: Schizophrenia Research
https://www.readbyqxmd.com/read/29545956/agranulocytosis-associated-with-topiramate-a-case-report-and-review-of-published-cases
#10
Saroj Lohani, Niranjan Tachamo, Salik Nazir, Anthony Donato
A 41-year-old female presented to the hospital with sore throat and shortness of breath. She was hypoxic with an oxygen saturation of 87% in room air. Physical examination revealed swollen uvula with exudates. She had been started on topiramate for treatment of migraine few months ago. The dose of topiramate was increased to 100 mg twice daily 2 weeks ago. Complete blood count revealed an absolute neutrophil count (ANC) of 8 c/mm3 . She was intubated and started on broad-spectrum antibiotics. She was transferred to our hospital on the fifth day of hospitalization...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29528898/new-findings-in-pharmacogenetics-of-schizophrenia
#11
Clement C Zai, Arun K Tiwari, Gwyneth C Zai, Miriam S Maes, James L Kennedy
PURPOSE OF REVIEW: This review highlights recent advances in the investigation of genetic factors for antipsychotic response and side effects. RECENT FINDINGS: Antipsychotics prescribed to treat psychotic symptoms are variable in efficacy and propensity for causing side effects. The major side effects include tardive dyskinesia, antipsychotic-induced weight gain (AIWG), and clozapine-induced agranulocytosis (CIA). Several promising associations of polymorphisms in genes including HSPG2, CNR1, and DPP6 with tardive dyskinesia have been reported...
May 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29522579/-proposal-of-informed-consent-by-representation-for-treatment-with-clozapine
#12
Ezequiel Mercurio, Demián Rodante
Clozapine-induced agranulocytosis, a potentially serious adverse effect, is a limiting factor for its therapeutic use, leading to the suspension of the drug. Its annual incidence in Argentina is 0.05%. In 2000, under provision number 935, the ANMAT approved the Monitoring Program for Ambulatory and Inpatient Patients Treated with Clozapine. In this provision arises the obligation to sign the informed consent where the patient is informed of the risks and benefts of the treatment. In psychiatric care practice patients may not possess, because of their altered psychic state, the level of competence necessary to sign informed consent for their treatment with clozapine...
September 2017: Vertex: Revista Argentina de Psiquiatriá
https://www.readbyqxmd.com/read/29519170/dress-syndrome-a-detailed-insight
#13
Sapan Kumar Behera, Saibal Das, Alphienes Stanley Xavier, Sandhiya Selvarajan
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a serious and potentially fatal adverse effect to therapeutic medications. The incidence of this condition varies among different ethnicities because of the difference in the genetic makeup. Though fever, rash and eosinophilia are essential features for the diagnosis of this syndrome, these vary from patient to patient along with the involvement of various organs such as liver, kidney, lungs, pancreas, etc. Some of the atypical features are dysphagia, agranulocytosis, and chylous ascites...
March 15, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29517519/sudden-death-in-schizophrenia
#14
Kevin J Li, Aaron P Greenstein, Lynn E Delisi
PURPOSE OF REVIEW: To examine the recent literature regarding sudden death in patients with schizophrenia and synthesize salient conclusions based on this evidence. RECENT FINDINGS: Sudden cardiac death (SCD) is the largest subset of sudden unexpected death (SUD), with up to 40% of SUD from cardiovascular causes. SCD has been associated with exposure to both first and second-generation antipsychotics. Clozapine [odds ratio (OR) 3.67, 95% confidence interval (CI) 1...
May 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29505490/clozapine-rechallenge-after-major-adverse-effects-clinical-guidelines-based-on-259-cases
#15
Peter Manu, Yevgeniya Lapitskaya, Atef Shaikh, Jimmi Nielsen
BACKGROUND: Clozapine is widely prescribed for treatment-refractory schizophrenia, but its use is limited by many potentially life-threatening adverse effects. The risk of rechallenge after these complications has never been comprehensively assessed in controlled studies. Thus, clinical guidelines must rely on the published case reports. The number of such reports is likely to increase over time, and updated analyses of larger samples are needed, as they may lead to changes in clinical guidelines...
March 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29503232/potentially-fatal-outcomes-associated-with-clozapine
#16
Kevin J Li, Ronald J Gurrera, Lynn E Delisi
Clozapine has been shown to be the most efficacious therapy for treatment resistant schizophrenia, estimated at one third of all schizophrenia cases. There is significant morbidity and mortality associated with clozapine including risk of agranulocytosis, aspiration pneumonia, bowel ischemia, myocarditis, seizures, and weight gain. Here we present a case of a 62-year-old man with chronic paranoid schizophrenia refractory to numerous antipsychotics who was started on clozapine therapy during an acute inpatient psychiatric admission...
March 1, 2018: Schizophrenia Research
https://www.readbyqxmd.com/read/29495370/clozapine-patients-at-the-interface-between-primary-and-secondary-care
#17
Marita Barrett, Anna Keating, Deirdre Lynch, Geraldine Scanlon, Mary Kigathi, Fidelma Corcoran, Laura J Sahm
Patients receiving clozapine must undergo routine blood monitoring to screen for neutropenia, and to monitor for potential agranulocytosis. In Cork University Hospital, Cork, Ireland, clozapine is dispensed in the hospital pharmacy and the pharmacists are not aware of co-prescribed medicines, potentially impacting upon patient safety. The aim of this study was to examine the continuity of care of patients prescribed clozapine. A retrospective audit was conducted on patients attending the clozapine clinic at Cork University Hospital and assessed patients' (i) independent living, (ii) co-prescribed medicines and (iii) knowledge of their community pharmacists regarding co-prescribed clozapine...
February 26, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29432206/evaluation-of-hematological-alterations-after-therapeutic-use-of-dipyrone-in-healthy-adults-a-prospective-study
#18
Ernane C de Souza, Dalyara M Matos, Milainy R Viana, Marcela C O Alvim, Herval L Bonfante, Alexandre F Pinto, Jorge W L Nascimento
BACKGROUND: Dipyrone is a non-narcotic analgesic/antipyretic widely used in some countries but prohibited in others due to suspected risk of agranulocytosis. The primary goal of this study was to evaluate hematological alterations in healthy adult volunteers after treatment with dipyrone. METHODS: The study enrolled 30 healthy volunteers of both genders, aged 19-37 years. They received tablets containing 500 mg of dipyrone sodium to be used four times daily for 7 consecutive days...
February 13, 2018: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29413518/unique-effects-of-clozapine-a-pharmacological-perspective
#19
Jibran Y Khokhar, Angela M Henricks, Emily D K Sullivan, Alan I Green
Schizophrenia is a heterogenous and severe neuropsychiatric disorder that affects nearly 1% of the population worldwide. Antipsychotic drugs are the mainstay of treatment, but not all patients with schizophrenia respond to treatment with these agents. Clozapine, the first atypical antipsychotic, is a highly effective medication for patients with schizophrenia who do not respond to other antipsychotics. Although clozapine tends not to produce extrapyramidal symptoms, other side effects of the drug (e.g., agranulocytosis, myocarditis, seizures) limit its widespread use...
2018: Advances in Pharmacology
https://www.readbyqxmd.com/read/29404875/acute-agranulocytosis-after-oral-administration-of-dabigatran-a-rare-case-report-and-a-short-review-of-literature
#20
Sergio Fasullo, Stefania Davì, Gioacchino Cosenza, Francesca Di Franco, Nicola La Manna, Alfonso Giubilato, Graziella Vetrano, Giorgio Maringhini
This case report describes agranulocytosis immediately after oral administration of dabigatran in a 68 years old man with atrial fibrillation (AF). Dabigatran is an oral, reversible and competitive thrombin inhibitor that has shown promising results. In patients with atrial fibrillation of RE-LY study (Randomized Evaluation of Long-Term Anticoagulant Therapy), dabigatran administered at a dose of 150 mg, as compared with warfarin, was associated with lower rates of stroke and systemic embolism but similar rates of major hemorrhage...
May 2018: Journal of Thrombosis and Thrombolysis
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