Agranulocytosis and near fatal sepsis due to 'Mexican aspirin' (dipyrone).

The use of "unconventional" or alternative medicine has been reported in up to one third of American households, yet only 28% report the use of such agents to their physician. We present here a case of near fatal sepsis and agranulocytosis. The agranulocytosis is attributed to the use of dipyrone (Dolo-Tiaminol), which the patient obtained in Mexico as a stronger form of generic "aspirin." The pyrazolone class of analgesics, of which dipyrone is a derivative, was introduced in the late 19th century and had a meteoric rise in use until an associated rise in fatal agranulocytosis was discovered. These agents were banned by the Food and Drug Administration (FDA) in 1977. Dipyrone is thought to induce agranulocytosis by inducing an antibody response. With the widespread use of alternative treatments, it is important for physicians to inquire as to the use of unprescribed drugs. Several resources are available to aid with the identification of foreign drugs.