Goudemand J, Plouvier J, Bauters F, Goudemand M
Sem Hop. 1976;52(25-28):1513-20.
The authors present 31 cases of acute agranulocytosis due to drugs. 27 resulted from amidopyrine poisoning and 4 were due to phenothiazines. The clinical picture in most cases, was that of severe septicemia with lesions of the mucosae. On blood count agranulocytosis was complete, associated on bone marrow examination with an appearance of selective hypoplasia of the granular series or an aspect of maturation blockage at the stage of the myelocyte or the metamyelocyte. The course was fatal in 6 cases. A search for leukocyte agglutinating antibodies, carried out in 29 cases, was positive in only 5 cases. These facts correspond, on the whole, to the, clinical and etiological data found in the literature. Although the agranulocytoses induced by phenothiazines, seem to be mainly of toxic origin, the agranulocytoses induced by amidopyrine associated both an immunological mechanism and a toxic mechanism. Among all the biological tests proposed, the most useful is the le ukocyte agglutination test, but the serological diagnosis is rarely conclusive.
作者报告了31例药物所致急性粒细胞缺乏症。其中27例由氨基比林中毒引起，4例由吩噻嗪类药物所致。多数病例的临床表现为严重败血症伴黏膜损害。血常规检查显示粒细胞缺乏完全，骨髓检查可见粒细胞系列选择性发育不全，或在中幼粒细胞或晚幼粒细胞阶段出现成熟阻滞。6例病程呈致命性。29例进行了白细胞凝集抗体检测，仅5例呈阳性。总体而言，这些事实与文献中报道的临床及病因学资料相符。虽然吩噻嗪类药物所致粒细胞缺乏症似乎主要源于毒性作用，但氨基比林所致粒细胞缺乏症涉及免疫机制和毒性机制。在所有建议的生物学检测中，最有用的是白细胞凝集试验，但血清学诊断很少能确诊。
