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Agranulocytosis

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https://www.readbyqxmd.com/read/27922762/nonchemotherapy-drug-induced-agranulocytosis-in-children-detected-by-a-prospective-pharmacovigilance-program
#1
Nicolás Medrano-Casique, Hoi Y Tong, Alberto M Borobia, Antonio J Carcas, Jesús Frías, Elena Ramírez
OBJECTIVES: A prospective evaluation of nonchemotherapy drug-induced agranulocytosis (DIA) cases, which are infrequent in the pediatric population. We characterize agranulocytosis cases and assess lab test differences between drug- and nondrug-induced agranulocytosis. METHODS: Through our Prospective Pharmacovigilance Program from Laboratory Signals at Hospital we detected pediatric agranulocytosis cases from July 2007 to December 2010. This program estimates the incidence, drug causality, clinical features, outcomes of DIA pediatric cases, and assesses laboratory differences with respect to non-DIA...
December 6, 2016: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/27912922/agranulocytosis-occurrence-following-recent-acute-infectious-mononucleosis
#2
Anthony F Massoll, Stanlyn C Powers, David P Betten
Infectious mononucleosis secondary to Epstein-Barr virus typically follows a relatively benign and self-limited course. A small subset of individuals may develop further progression of disease including hematologic, neurologic, and cardiac abnormalities. A mild transient neutropenia occurring during the first weeks of acute infection is a common finding however in rare cases a more profound neutropenia and agranulocytosis may occur up to 6weeks following the onset of initial symptoms. We describe the case of an 18-year-old woman who presented 26days following an acute infectious mononucleosis diagnosis with agranulocytosis and fever...
November 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27891482/treatment-emergent-agranulocytosis-with-skin-and-gingival-lesions-in-a-chronic-lymphocytic-leukemia-patient-a-case-report
#3
Ramesh Amirisetty, Varun Zade, Meenakshi Boddun, Rolly Gupta, Micky Kumari, Hema Suryawanshi
Chronic Lymphocytic Leukaemia (CLL) is a monoclonal lymphoid malignancy characterized by progressive accumulation of small, mature but functionally incompetent neoplastic lymphocytes in the peripheral blood, bone marrow and lymphoid organs. Patients present a variable course and may not require early intervention unlike other malignancies. Patients with rapidly deteriorating blood counts, and organomegaly need treatment. Alkylating agent live Bendamustine combined with Rituximab, anti-CD 20 monoclonal antibody have shown promising results in such patients...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27872678/erratum-antithyroid-drug-induced-agranulocytosis-what-still-we-need-to-learn
#4
(no author information available yet)
[This corrects the article DOI: 10.11604/pamj.2016.23.27.8365.].
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#5
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27829837/severe-agranulocytosis-following-simultaneous-administration-of-chlorpromazine-and-trimethoprim-sulfamethoxazole-in-a-patient-with-sepsis-a-possible-toxic-combination
#6
Anil Jha, Hassan Ghoz, Nicholas James
Background. Chlorpromazine and trimethoprim-sulfamethoxazole (TMP/SMX) are two commonly prescribed medications by physicians. Either of those medications could cause fatal drug-induced agranulocytosis, with an unclear underlying mechanism. The likelihood of simultaneous prescription of both medications is high and could hypothetically result in severe agranulocytosis that is resistant to treatment. Case Presentation. We are presenting a case of a patient with psychosis on chlorpromazine who was prescribed TMP/SMX for a urinary tract infection...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27826741/the-porirua-protocol-in-the-treatment-of-clozapine-induced-gastrointestinal-hypomotility-and-constipation-a-pre-and-post-treatment-study
#7
Susanna Every-Palmer, Pete M Ellis, Mike Nowitz, James Stanley, Eve Grant, Mark Huthwaite, Helen Dunn
BACKGROUND: Clozapine, an antipsychotic used in treatment-resistant schizophrenia, causes slow gastrointestinal transit in 50-80% of patients. Clozapine-induced gastrointestinal hypomotility is both common and serious, and potential complications include severe constipation, ileus, bowel obstruction and related complications, with a higher mortality rate than clozapine-related agranulocytosis. Little evidence exists on its prevention and management. METHOD: Using a well-validated radiopaque marker ('Metcalf') method, we compared colonic transit times (CTTs) of clozapine-treated inpatients not receiving laxatives with their transit times when receiving laxatives, with treatment prescribed according to the Porirua Protocol for clozapine-related constipation (docusate and senna augmented by macrogol 3350 in treatment-resistant cases)...
November 8, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27824551/cocaine-induced-vasculitis
#8
REVIEW
Mark Berman, Daphna Paran, Ori Elkayam
The use of cocaine continues to grow worldwide. One of the possible side-effects of cocaine is vasculitis. Two distinct vasculitic syndromes have been described due to cocaine. One is cocaine-induced midline destructive lesion, secondary to a direct vasoconstrictor effect of cocaine, inducing ischemic necrosis of the septal cartilage and perforation of the nasal septum, mimicking findings of granulomatosis with polyangiitis in the upper airways. The other is ANCA-associated vasculitis, attributed to the levamisole component that contaminates about 70% of the cocaine...
October 31, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27818635/pharmacogenetics-and-predictive-testing-of-drug-hypersensitivity-reactions
#9
REVIEW
Ruwen Böhm, Ingolf Cascorbi
Adverse drug reactions adverse drug reaction (ADR) occur in approximately 17% of patients. Avoiding ADR is thus mandatory from both an ethical and an economic point of view. Whereas, pharmacogenetics changes of the pharmacokinetics may contribute to the explanation of some type A reactions, strong relationships of genetic markers has also been shown for drug hypersensitivity belonging to type B reactions. We present the classifications of ADR, discuss genetic influences and focus on delayed-onset hypersensitivity reactions, i...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27800022/evidence-for-the-use-of-pimavanserin-in-the-treatment-of-parkinson-s-disease-psychosis
#10
REVIEW
Harini Sarva, Claire Henchcliffe
Parkinson's disease (PD) is a progressive neurodegenerative disorder with both motor and nonmotor symptoms (NMS), leading to significant morbidity and caregiver burden. Psychosis is common but is under recognized by physicians. When present, it increases the patient's risk of hospitalization and nursing home placement and caregiver burden. Although the atypical antipsychotic agent, clozapine, has been considered the gold standard treatment, severe agranulocytosis in 0.38% of patients and more commonly milder leukopenia, resulting in frequent blood testing, limit its use...
November 2016: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/27778386/case-of-pediatric-bullous-systemic-lupus-erythematosus-treated-with-intravenous-immunoglobulin
#11
Margit Juhász, Megan Rogge, Mary Chen, Annette Czernik, Soo Jung Kim, Lauren Geller
This is a case report of a 16-year-old girl recently diagnosed with systemic lupus erythematosus (SLE) who presented with multiple blisters on the face, hands, arms, legs, trunk, and vaginal and oral mucosa. Skin biopsy was consistent with bullous SLE (BSLE). Dapsone is often the first-line treatment option for BSLE, but the patient's history of anemia and leukopenia and long-term immunosuppression requirement for her systemic symptoms raised concerns about dapsone and bone marrow toxicity, especially hemolytic anemia and agranulocytosis...
October 25, 2016: Pediatric Dermatology
https://www.readbyqxmd.com/read/27766404/-dipyrone-metamizole-considerations-on-monitoring-for-early-detection-of-agranulocytosis
#12
U M Stamer, U Gundert-Remy, E Biermann, J Erlenwein, W Meiβner, S Wirz, T Stammschulte
BACKGROUND: Dipyrone (metamizole) is a non-opioid analgesic commonly used in Germany, which can, in very rare cases, cause life-threatening agranulocytosis. The prescribing information calls for regular monitoring of the differential blood count in cases of long-term treatment. However, there is uncertainty about how this testing should be handled in practice. OBJECTIVES: Which recommendations can be derived from the published literature for evaluating blood cell counts during treatment with metamizole and which other options for monitoring exist? METHODS: Data from recent epidemiological studies, reviews, and spontaneously reported cases were evaluated...
October 20, 2016: Der Schmerz
https://www.readbyqxmd.com/read/27759628/steroid-sparing-effect-and-toxicity-of-dapsone-treatment-in-giant-cell-arteritis-a-single-center-retrospective-study-of-70-patients
#13
Kim Heang Ly, François Dalmay, Guillaume Gondran, Sylvain Palat, Holy Bezanahary, Anne Cypierre, Anne-Laure Fauchais, Eric Liozon
Although a glucocorticoid (GC)-sparing strategy is needed for patients with giant cell arteritis (GCA) suffering from refractory disease or serious treatment-related complications, evidence of efficacy in this setting of immunosuppressive drugs and biotherapies is lacking. Herein, we evaluated the GC-sparing effects and tolerability of addition of dapsone (DDS) to prednisone therapy in patients with GCA. We retrospectively assessed data on 18 GCA patients who received DDS as a first-line treatment (DDS-1 group) and 52 patients who received it as a second- or third-line treatment for refractory GCA, with or without excessive GC-related toxicity (DDS-2 group)...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27747721/rhabdomyolysis-in-clozapine-overdose
#14
Frank G A Jansman, Heleen A Crommelin, Freek J A H van Hout, Jan Meulenbelt
CONTEXT: Clozapine is used for decennia for the treatment of schizophrenia. Agranulocytosis, diabetic ketoacidosis, gastrointestinal hypomotility, and myocarditis are well-known adverse effects of clozapine, which are sometimes life threatening. Here we report a case of rhabdomyolysis upon an acute overdose of clozapine. CASE: A male patient, 36 years, with elevated creatinine kinase levels (9899 U/l), developed rhabdomyolysis afterafter admission to the emergency department...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27747601/idiosyncratic-drug-induced-severe-neutropenia-and-agranulocytosis-in-elderly-patients-%C3%A2-75%C3%A2-years-a-monocentric-cohort-study-of-61-cases
#15
Rachel Mourot-Cottet, Frédéric Maloisel, François Séverac, Olivier Keller, Thomas Vogel, Martine Tebacher, Jean-Christophe Weber, Georges Kaltenbach, Jacques-Eric Gottenberg, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht, Emmanuel Andrès
BACKGROUND: Little data is currently available in the literature on neutropenia and agranulocytosis in the elderly, and, to our knowledge, idiosyncratic drug-induced agranulocytosis is particularly poorly covered, or not at all. OBJECTIVE: We herein describe the clinical picture and outcome of patients aged ≥75 years with established idiosyncratic drug-induced agranulocytosis. PATIENTS AND METHODS: Data from 61 patients over 75 years old with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed...
December 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27732102/guide-to-the-management-of-clozapine-related-tolerability-and-safety-concerns
#16
Leslie Citrome, Joseph P McEvoy, Stephen R Saklad
Clozapine is a highly effective antipsychotic medication, which provides a range of significant benefits for patients with schizophrenia, and is the standard of care for treatment-resistant schizophrenia as well as for reducing the risk of suicidal behaviors in schizophrenia and schizoaffective disorder. However, clozapine is widely underutilized, largely because prescribing clinicians lack experience in prescribing it and managing its adverse events (AEs). Clozapine is associated with three uncommon but immediately dangerous AEs-agranulocytosis, myocarditis/cardiomyopathy, and seizures-as well as AEs that may become dangerous if neglected, including weight gain, metabolic syndrome and constipation, and others that are annoying or distressing such as sedation, nighttime enuresis and hypersalivation...
2016: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/27729671/ziprosidone-induced-transient-agranulocytosis-delayed-onset-of-cardiac-adverse-effects-with-fingolimod-telmisartan-induced-myotoxicity-severe-dilated-cardiomyopathy-induced-by-adalimumab-and-ustekinumab
#17
EDITORIAL
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: mmancano@temple.edu). Your report will be published anonymously unless otherwise requested...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27713676/meropenem-induced-neutropenia-in-a-neonate
#18
Joseph S Van Tuyl, Aubrey N Jones, Peter N Johnson
Postmarketing surveillance has associated meropenem with the development of hematologic abnormalities, including agranulocytosis, neutropenia, and leukopenia, but the exact incidence in children is unknown. The case describes a full-term, 26-day-old neonate admitted for a sepsis workup. She was found to have a blood culture positive for Enterobacter cloacae and suspected meningitis and was initiated on meropenem 40 mg/kg/dose intravenously every 8 hours. On day 14 of antibiotic treatment, the patient developed an isolated neutropenia with an absolute neutrophil count of 288 cells/mm(3)...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27708979/hydroxychloroquine-induced-agranulocytosis-in-a-patient-with-long-term-rheumatoid-arthritis
#19
Edward Sames, Heather Paterson, Charles Li
Agranulocytosis is a rare and little-known side effect of hydroxychloroquine use. This report describes the case of a 71-year-old woman with poorly controlled rheumatoid arthritis who developed agranulocytosis after several months of hydroxychloroquine therapy. She had been on several different disease-modifying antirheumatic drugs, including methotrexate and leflunomide, for her rheumatoid arthritis. Treatment became complicated following a diagnosis of leflunomide-induced pulmonary fibrosis that was discovered after an intensive care unit (ICU) admission for severe Pseudomonas pneumonia...
June 2016: Eur J Rheumatol
https://www.readbyqxmd.com/read/27704220/a-review-of-the-safety-of-clozapine-during-pregnancy-and-lactation
#20
Taylor M Mehta, Ryan J Van Lieshout
Clozapine is an antipsychotic used in the management of treatment-resistant schizophrenia. However, little is known about clozapine use during pregnancy and lactation, or its impact on the mother, foetus, and infant. This review aims to summarize the available literature on the safety of clozapine use during the perinatal period. EMBASE, PsycINFO, and MEDLINE were searched from their inceptions through June 2016. The review encompasses 21 studies that have examined clozapine use during pregnancy and lactation...
October 4, 2016: Archives of Women's Mental Health
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