Schär B, Meier C, Affolter H
Medizinische Abteilung, St. Claraspital Basel.
Schweiz Med Wochenschr. 1994 Apr 2;124(13):545-9.
Agranulocytosis is a rare but sometimes extremely dangerous adverse drug reaction which can be induced by almost any drug. We report the case of a 89-year-old man with a well-documented granulocyte chart, who received allopurinol in addition to preexisting therapy with cardiovascular drugs. Three weeks later agranulocytosis was found which bone-marrow biopsy indicated was drug-induced. After cessation of all drugs, isolation and antibiotic therapy, the leukocyte count returned to normal but the patient died four weeks later from progressive renal failure. A relation between allopurinol therapy and agranulocytosis was presumed. The drugs which might have caused this adverse reaction are discussed. The incidence, signs, symptoms and treatment are summarized and proposals are made concerning the action to be taken in the event of drug-induced agranulocytosis.
粒细胞缺乏症是一种罕见但有时极其危险的药物不良反应，几乎任何药物都可能诱发。我们报告一例89岁男性病例，其粒细胞计数记录完整，除了已有的心血管药物治疗外，还接受了别嘌醇治疗。三周后发现粒细胞缺乏症，骨髓活检表明是药物所致。停用所有药物、隔离并进行抗生素治疗后，白细胞计数恢复正常，但患者四周后死于进行性肾衰竭。推测别嘌醇治疗与粒细胞缺乏症之间存在关联。讨论了可能导致这种不良反应的药物。总结了其发病率、体征、症状和治疗方法，并就药物性粒细胞缺乏症发生时应采取的措施提出了建议。
