Navarro-Martínez R, Chover-Sierra E, Cauli O
Department of Nursing, University of Valencia, Valencia, Spain.
Department of Nursing, University of Valencia, Valencia, Spain
Hum Exp Toxicol. 2016 Mar;35(3):244-50. doi: 10.1177/0960327115580603. Epub 2015 Apr 5.
Drug-induced agranulocytosis is a rare haematological disorder considered as severe adverse drug reaction. Due to its low incidence, the number of studies are low and the variability of clinical features and presentation in hospitalized patients is rarely described. Awe performed an observational, transversal and retrospective study in the haematology and toxicology unit in a tertiary hospital located in Spain (Valencia) (1996-2010) in order to assess its incidence, the drugs involved, the management and outcomes of drug-induced agranulocytosis. Twenty-one cases of agranulocytosis were retrieved. All of them presented severe and symptomatic agranulocytosis (fever and infection). The most common drug associated with drug-induced agranulocytosis was metamizole administration but other drugs belonging to different pharmacological classes as well (carbimazol, sulfasalazine, bisoprolol, itraconazole, amitryptiline, ketorolac and claritomicine+cefuroxime). No differences between sex and age were found in relationship with the manifestations or course of agranulocytosis. In contrast, a significantly negative association was found between age of patients and the percentage of increase in neutrophil count. Administration of human granulocyte colony-stimulating factor did not significantly enhance the recovery of the process or the restoration of leucocytes count, suggesting a limited utility in this type of agranulocytosis.
药物性粒细胞缺乏症是一种罕见的血液系统疾病，被视为严重的药物不良反应。由于其发病率低，相关研究数量较少，住院患者临床特征和表现的变异性也鲜有描述。我们在西班牙巴伦西亚一家三级医院的血液学和毒理学科室进行了一项观察性、横断面和回顾性研究（1996 - 2010年），以评估药物性粒细胞缺乏症的发病率、相关药物、治疗及转归。共检索到21例粒细胞缺乏症病例。所有病例均表现为严重且有症状的粒细胞缺乏症（发热和感染）。与药物性粒细胞缺乏症相关最常见的药物是安乃近，但也有其他属于不同药理类别的药物（卡比马唑、柳氮磺胺吡啶、比索洛尔、伊曲康唑、阿米替林、酮咯酸以及克拉霉素+头孢呋辛）。在粒细胞缺乏症的表现或病程方面，未发现性别和年龄存在差异。相反，患者年龄与中性粒细胞计数增加百分比之间存在显著的负相关。使用人粒细胞集落刺激因子并未显著促进病情恢复或白细胞计数恢复，提示其在这类粒细胞缺乏症中的效用有限。
