Paitel J F, Stockemer V, Dorvaux V, Witz F, Guerci A, Lederlin P
Service de médecine A, CHU Nancy-Brabois, Vandoeuvre-lès-Nancy, France.
Rev Med Interne. 1995;16(7):495-9. doi: 10.1016/0248-8663(96)80745-4.
Between 1982 and 1993, 30 patients were treated for drug-induced agranulocytosis. They did not receive cytotoxic chemotherapy nor radiotherapy during the past 6 months. There is a higher incidence in women (21 females, nine males). Mean age is 59.3 years old. The drug could be found in 25 cases including noramidopyrine five cases, antithyroid drugs four cases, non steroidal anti-inflammatories drugs four cases. Five patients died of infection during agrulocytosis. Sepsis was documented in three cases. We used hematopoietic growth factors in two cases. Neutrophils rose up to 0.5.10(9)/l between 2 to 14 days after the diagnosis and 1.10(9)/l between 3 to 16 days. Time when absolute neutrophil count was less than 0.5.10(9)/l was shorter (p = 0.008) when bone marrow was rich with maturation arrest but with few or no mature forms rather than reduction of granulocytic precursors. By comparison with a similar study made in the same institution between 1971 and 1981, there were fewer cases each year. Drugs involved were not similar: phenicols were not found, reference to noramidopyrine is less frequent. Now antithyroid drugs is becoming one of the most important etiologies.
1982年至1993年间，30例患者接受了药物性粒细胞缺乏症的治疗。他们在过去6个月内未接受过细胞毒性化疗或放疗。女性发病率较高（21例女性，9例男性）。平均年龄为59.3岁。25例中可找到致病药物，其中含氨基比林5例、抗甲状腺药物4例、非甾体抗炎药4例。5例患者在粒细胞缺乏症期间死于感染。3例有脓毒症记录。2例使用了造血生长因子。诊断后2至14天中性粒细胞升至0.5×10⁹/L，3至16天升至1×10⁹/L。当骨髓中成熟停滞但成熟形式很少或没有而不是粒细胞前体减少时，绝对中性粒细胞计数低于0.5×10⁹/L的时间较短（p = 0.008）。与同一机构在1971年至1981年间进行的类似研究相比，每年的病例较少。涉及的药物不同：未发现氯霉素，提及氨基比林的频率较低。现在抗甲状腺药物正成为最重要的病因之一。
