Cardiology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
Internal Medicine Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal.
BMJ Case Rep. 2021 Nov 11;14(11):e246788. doi: 10.1136/bcr-2021-246788.
Idiosyncratic drug-induced agranulocytosis is a rare life-threatening adverse reaction characterised by an absolute neutrophil count <500 cells/μL of blood. Nitrofurantoin has been associated with haematological adverse events, but few agranulocytosis cases worldwide have been reported. We present a case of a 68-year-old woman who presented with fever and agranulocytosis following treatment with nitrofurantoin. Extensive workup for agranulocytosis, including a bone marrow aspirate, was unremarkable. Treatment with nitrofurantoin was discontinued, which led to a complete recovery of the complete blood count. This case stresses the importance of monitoring treatments, given that widely used drugs are not free from severe adverse reactions.
特发性药物诱导的粒细胞缺乏症是一种罕见的危及生命的不良反应,其特征是血液中绝对中性粒细胞计数 <500 个/μL。硝基呋喃妥因与血液学不良事件有关,但全球报告的粒细胞缺乏症病例很少。我们报告了一例 68 岁女性在使用硝基呋喃妥因治疗后出现发热和粒细胞缺乏症。对粒细胞缺乏症进行了广泛的检查,包括骨髓抽吸,结果无明显异常。停用硝基呋喃妥因治疗后,全血细胞计数完全恢复。该病例强调了监测治疗的重要性,因为广泛使用的药物并非没有严重的不良反应。