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    Carbamazepine-induced Life-threatening Stevens-Johnson Syndrome and Agranulocytosis: The Maiden Case.
    J Clin Diagn Res 2016 Dec 1;10(12):FD01-FD03. Epub 2016 Dec 1.
    Associate Professor, Department of Pharmacology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
    Stevens-Johnson syndrome is one of the few dermatological emergencies in clinical practice. The syndrome is often secondary to the usage of drugs, of which allopurinol, penicillins, sulfa drugs, ibuprofen, sodium valproate, phenytoin, lamotrigine and carbamazepine are commonly implicated. Agranulocytosis is the existence of a clinically significant reduction in neutrophil count. Read More

    [Pathogens of infections in the induction period of childhood acute lymphoblastic leukemia and drug resistance of isolated strains].
    Zhongguo Dang Dai Er Ke Za Zhi 2017 Feb;19(2):176-181
    Fujian Institute of Hematology/Fujian Key Laboratory on Hematology/Fujian Medical University Union Hospital, Fuzhou 350001, China.
    Objective: To investigate the infections occurring in the induction period of childhood acute lymphoblastic leukemia (ALL), the pathogens of the infections, and drug resistance of isolated strains.

    Methods: A retrospective analysis was performed for the clinical data of 130 children with newly-diagnosed childhood ALL. Infections occurring during the induction chemotherapy, pathogenic strains, and drug-resistance spectrum were analyzed. Read More

    Characterization of Admission Types in Medically Hospitalized Patients Prescribed Clozapine.
    Psychosomatics 2016 Nov 18. Epub 2016 Nov 18.
    Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
    Background: Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia; however, rigorous monitoring is required to prevent or detect adverse drug events that contribute to morbidity and mortality. In addition to the Food and Drug Administration (FDA) boxed safety warnings specific to clozapine (agranulocytosis, hypotension, seizures, and cardiomyopathy/myocarditis), other adverse events such as pneumonia and gastrointestinal hypomotility have been reported in the literature to result in hospitalization.

    Objective: To explore the reasons for medical hospitalization in patients prescribed clozapine, a retrospective chart review was completed. Read More

    Clozapine and long-acting injectable antipsychotic combination: A retrospective one-year mirror-image study.
    Schizophr Res 2017 Jan 27. Epub 2017 Jan 27.
    Department of Psychiatry, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894, Paris, France; INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, UMR S894, Paris, France.
    To evaluate efficacy and tolerability of the combination of clozapine with an antipsychotic long-acting injectable (LAI) in multi-episode patients with schizophrenia or schizoaffective disorder. Efficacy and tolerability were assessed in seventeen patients admitted to a hospital in Paris between January 2010 and June 2015, using a one-year mirror-image design. Number and length of hospitalizations significantly decreased after introducing the combination (2. Read More

    ANCA Associated Vasculitis Secondary to Levamisole-Adultered Cocaine with Associated Membranous Nephropathy: A Case Series.
    Am J Nephrol 2017 Jan 28;45(3):209-216. Epub 2017 Jan 28.
    Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
    Background: Cocaine is a risk factor for acute kidney injury and chronic kidney disease with progression to end-stage renal disease. Levamisole is an adulterant that is added to cocaine to enhance its euphoric effects. Levamisole-adulterated cocaine (LAC) is associated with the distinct clinical syndromes of agranulocytosis, leukocytoclastic vasculitis, cocaine-induced midline destructive lesions (CIMDL), and ANCA-associated vasculitis (AAV) with pauci-immune necrotizing glomerulonephritis. Read More

    The effect of mirtazapine on dopaminergic psychosis and dyskinesia in the parkinsonian marmoset.
    Psychopharmacology (Berl) 2017 Jan 27. Epub 2017 Jan 27.
    Centre de Recherche du Centre Hospitalier de l'Université de Montréal, R09.436, 900 Rue St-Denis, Montreal, QC, H2X 0A9, Canada.
    Background: Parkinson's disease (PD) psychosis is encountered in as many as 50% of patients with advanced disease. Treatment options for PD psychosis are few. In fact, only clozapine and pimavanserin have shown efficacy in randomised controlled trials. Read More

    Associations of Antifungal Treatments With Prevention of Fungal Infection in Critically Ill Patients Without Neutropenia.
    JAMA 2017 01;317(3):311-312
    Department of Biopathology and Medical Biotechnologies, Section of Anesthesia Analgesia Intensive Care and Emergency, University of Palermo, Palermo, Italy.
    Clinical Question: Are antifungal agents associated with lower rates of mortality and invasive fungal infections when administered before definitive diagnosis of an invasive fungal infection in critically ill patients without neutropenia?

    Bottom Line: Antifungal treatment administered prior to diagnosis of an invasive fungal infection is not associated with either higher or lower rates of all-cause mortality. Antifungal treatment in this setting is associated with lower rates of invasive fungal infections compared with placebo or no intervention in critically ill patients without neutropenia, but the quality of the evidence is low. Read More

    COKE LIVe: recurrent vasculitis secondary to cocaine contaminated with levamisole.
    Acute Med 2016 ;15(4):206-208
    Levamisole-induced vasculitis (LIV) is becoming an increasingly common entity secondary to both rising cocaine use in the UK and high levels of adulteration of cocaine with various contaminants. We report the first documented case of LIV secondary to adulterated cocaine in Ireland, which presented as a 6-year history of recurrent vasculitis of unknown aetiology. Classically, LIV is diagnosed by a combination of positive ANCA serology and agranulocytosis however, given the frequency of cocaine use, we urge acute physicians to consider the diagnosis in cases of typical retiform (angulated) purpura in association with a history of cocaine use. Read More

    Antithyroid Drug-Induced Agranulocytosis: State of the Art on Diagnosis and Management.
    Drugs R D 2017 Jan 19. Epub 2017 Jan 19.
    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.
    Agranulocytosis is a rare but serious complication of antithyroid drug therapy, and an up-to-date understanding of this topic is important. Both direct toxicity and immune-mediated responses have been described as possible mechanisms. Some major susceptibility loci have recently been identified, which may lead the diagnosis of agranulocytosis into a genomic era. Read More

    Periodic Granulocyte Count Measuring Is Useful for Detecting Asymptomatic Agranulocytosis in Antithyroid Drug-Treated Patients with Graves' Disease.
    Eur Thyroid J 2016 Dec 6;5(4):253-260. Epub 2016 Sep 6.
    Kuma Hospital, Kobe, Japan.
    Objective: Finding agranulocytosis (AG) at an early stage is important to improve outcome, but periodic granulocyte count monitoring is not generally recommended for patients with Graves' disease, because AG develops suddenly.

    Method: At the Kuma Hospital, Graves' patients under antithyroid drug (ATD) treatment in an outpatient clinic have a granulocyte count examination during each visit, and if it is <1,000/μl, a warning is immediately sent to the patient's physician. We evaluated the usefulness of this system. Read More

    Incidence and risk estimate of drug-induced agranulocytosis in Hong Kong Chinese. A population-based case-control study.
    Pharmacoepidemiol Drug Saf 2017 Jan 13. Epub 2017 Jan 13.
    Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong.
    Purpose: Drug-induced agranulocytosis is a rare but life-threatening adverse drug reaction. Its epidemiology in Chinese is largely unknown. This study aimed to estimate the incidence, mortality, and risk of the drugs associated with agranulocytosis in Hong Kong Chinese. Read More

    Febuxostat-induced agranulocytosis in an end-stage renal disease patient: A case report.
    Medicine (Baltimore) 2017 Jan;96(2):e5863
    aMedical Department, Chung Shan Medical University, Taichung bDepartment of Internal Medicine, Kaohsiung Chang-Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    Introduction: Febuxostat, a nonpurine xanthine oxidase inhibitor, is approved as the first-line urate-lowering therapy in gout patients with normal renal function or mild to moderate renal impairment. The most common adverse effects of febuxostat are liver function test abnormalities, diarrhea, and skin rash. However, there is insufficient data in patients with severe renal impairment and end-stage renal disease (ESRD). Read More

    Idiosyncratic drug-induced neutropenia & agranulocytosis.
    QJM 2017 Jan 9. Epub 2017 Jan 9.
    Backgroud: Few data is currently available on neutropenia and agranulocytosis related to drug intake. We report here data on 203 patients with established idiosyncratic drug-induced agranulocytosis, followed up in a referral centre within a university hospital.

    Patients And Methods: Data from 203 patients with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed. Read More

    Rituximab: 13 open questions after 20years of clinical use.
    Cancer Treat Rev 2017 Feb 22;53:38-46. Epub 2016 Dec 22.
    Oncology Institute of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona, Switzerland. Electronic address:
    Rituximab improved the prognosis of all B-cell derived lymphoproliferative diseases, but despite 20years of intensive use, it remains a drug with a number of still obscure characteristics and unanswered questions. These include the mechanism of action and of resistance, the optimal schedule, the interaction with chemotherapy, as well as predictive factors for response rate and duration. Despite being very well tolerated, the question of its long term side effects and the risks of the administration near to a pregnancy have only recently been addressed. Read More

    Pregnancy complicated with agranulocytosis.
    Medicine (Baltimore) 2016 Dec;95(52):e5717
    Emergency Department, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
    Rationale: Pregnancy is a complicated physiological process. Physiological leukocytosis often takes place and it is primarily related to the increased circulation of neutrophils, especially during the last trimester of pregnancy. Noncongenital agranulocytosis during pregnancy is rare and reported only occasionally, while in most of the cases, the agranulocytosis has already occurred prior to pregnancy or induced by identified factors such as antibiotics, antithyroid agents, or cytotoxic agents. Read More

    Neutropenia is independently associated with sub-therapeutic serum concentration of vancomycin.
    Clin Chim Acta 2017 Feb 23;465:106-111. Epub 2016 Dec 23.
    Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
    Background: We aimed to identify the impact of the presence of neutropenia on serum vancomycin concentration (SVC).

    Methods: A retrospective study was conducted from January 2005 to December 2015. The study population was comprised of adult patients who were performed serum concentration of vancomycin. Read More

    GM-CSF treatment is not effective in congenital neutropenia patients due to its inability to activate NAMPT signaling.
    Ann Hematol 2017 Mar 14;96(3):345-353. Epub 2016 Dec 14.
    Department of Hematology, Oncology and Bone Marrow Transplantation, Children's Hospital, University Hospital Tübingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany.
    Severe congenital neutropenia (CN) is a bone marrow failure syndrome characterized by an absolute neutrophil count (ANC) below 500 cells/μL and recurrent, life-threatening bacterial infections. Treatment with granulocyte colony-stimulating factor (G-CSF) increases the ANC in the majority of CN patients. In contrary, granulocyte-monocyte colony-stimulating factor (GM-CSF) fails to increase neutrophil numbers in CN patients in vitro and in vivo, suggesting specific defects in signaling pathways downstream of GM-CSF receptor. Read More

    Palbociclib and Letrozole in Advanced Breast Cancer.
    N Engl J Med 2016 Nov;375(20):1925-1936
    From the Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine at the University of California, Los Angeles, Santa Monica (R.S.F., D.J.S.), the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco (H.S.R.), and Pfizer, La Jolla (E.G., D.R.L., S.R.) - all in California; Hospital Gregorio Maranon, Universidad Complutense, Madrid (M.M.); U.S. Oncology Research, The Woodlands, TX (S.J.); Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea (S.-A.I.); British Columbia Cancer Agency, Vancouver, Canada (K.G.); Brustzentrum der Universität München (LMU), Munich, Germany (N.H.); State Budget Medical Institution Republican Clinical Oncology, Ufa, Russia (O.N.L.); All-Ireland Cooperative Oncology Research Group, Dublin (J.M.W.); M.D. Anderson Cancer Center, University of Texas, Houston (S.M.); and Institut Curie, Paris (V.D.).
    Background A phase 2 study showed that progression-free survival was longer with palbociclib plus letrozole than with letrozole alone in the initial treatment of postmenopausal women with estrogen-receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. We performed a phase 3 study that was designed to confirm and expand the efficacy and safety data for palbociclib plus letrozole for this indication. Methods In this double-blind study, we randomly assigned, in a 2:1 ratio, 666 postmenopausal women with ER-positive, HER2-negative breast cancer, who had not had prior treatment for advanced disease, to receive palbociclib plus letrozole or placebo plus letrozole. Read More

    Neutropenia and agranulocytosis during treatment of schizophrenia with clozapine versus other antipsychotics: an observational study in Iceland.
    BMC Psychiatry 2016 Dec 12;16(1):441. Epub 2016 Dec 12.
    Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
    Background: Data on the haematological outcomes of patients who continue clozapine treatment following neutropenia are very rare as even mild neutropenia results in mandatory discontinuation of clozapine in most countries. However, in Iceland where clozapine monitoring is less stringent allows an observational study to be done on the risk of agranulocytosis and neutropenia during treatment with clozapine compared with other antipsychotics among patients with schizophrenia.

    Methods: The present study is a part of a wider ongoing longitudinal study of schizophrenia in Iceland. Read More

    Clozapine-induced agranulocytosis: Evidence for an immune-mediated mechanism from a patient-specific in-vitro approach.
    Toxicol Appl Pharmacol 2017 Feb 6;316:10-16. Epub 2016 Dec 6.
    Dept. of Psychiatry, Campus Benjamin Franklin, Charité, University Medicine Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany. Electronic address:
    Use of the atypical antipsychotic clozapine (CZP) is compromised by the risk of potentially fatal agranulocytosis/granulocytopenia (CIAG). To address this, we have established a simple, personalized cell culture-based strategy to identify CIAG-susceptible patients, hypothesizing that an immunogenic and possibly haptene-based mechanism underlies CIAG pathophysiology. To detect a putative haptene-induced response to CZP in vitro exposure, a traditional lymphocyte stimulation assay was adapted and applied to patient-specific peripheral blood-derived mononuclear cells (PBMC). Read More

    Probable clozapine-induced parenchymal lung disease and perimyocarditis: a case report.
    BMC Psychiatry 2016 Dec 8;16(1):438. Epub 2016 Dec 8.
    Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway.
    Background: Clozapine is the archetypical atypical antipsychotic, its primary indication being treatment resistant schizophrenia. Severe side effects caused by clozapine, including leukopenia, agranulocytosis, and myocarditis, are well known. A rarely described side effect is concurrent perimyocarditis and parenchymal lung disease. Read More

    Nonchemotherapy drug-induced agranulocytosis in children detected by a prospective pharmacovigilance program.
    Pediatr Hematol Oncol 2016 Oct - Nov;33(7-8):441-456. Epub 2016 Dec 6.
    a Department of Clinical Pharmacology , La Paz University Hospital, IdiPAZ, School of Medicine, Autonomous University of Madrid , Madrid , Spain.
    Objectives: A prospective evaluation of nonchemotherapy drug-induced agranulocytosis (DIA) cases, which are infrequent in the pediatric population. We characterize agranulocytosis cases and assess lab test differences between drug- and nondrug-induced agranulocytosis.

    Methods: Through our Prospective Pharmacovigilance Program from Laboratory Signals at Hospital we detected pediatric agranulocytosis cases from July 2007 to December 2010. Read More

    Agranulocytosis occurrence following recent acute infectious mononucleosis.
    Am J Emerg Med 2016 Nov 19. Epub 2016 Nov 19.
    Department of Emergency Medicine, Michigan State University College of Human Medicine, Sparrow Health System, Lansing, MI, United States. Electronic address:
    Infectious mononucleosis secondary to Epstein-Barr virus typically follows a relatively benign and self-limited course. A small subset of individuals may develop further progression of disease including hematologic, neurologic, and cardiac abnormalities. A mild transient neutropenia occurring during the first weeks of acute infection is a common finding however in rare cases a more profound neutropenia and agranulocytosis may occur up to 6weeks following the onset of initial symptoms. Read More

    Treatment Emergent Agranulocytosis with Skin and Gingival Lesions in a Chronic Lymphocytic Leukemia Patient: A Case Report.
    J Clin Diagn Res 2016 Oct 1;10(10):ZD13-ZD16. Epub 2016 Oct 1.
    Professor and Head, Department of Oral Pathology and Microbiology, Chhattisgarh Dental College and Research Institute , Rajnandgaon, Chhattisgarh, India .
    Chronic Lymphocytic Leukaemia (CLL) is a monoclonal lymphoid malignancy characterized by progressive accumulation of small, mature but functionally incompetent neoplastic lymphocytes in the peripheral blood, bone marrow and lymphoid organs. Patients present a variable course and may not require early intervention unlike other malignancies. Patients with rapidly deteriorating blood counts, and organomegaly need treatment. Read More

    [Guidelines for the prescription of mood stabilizers for adolescents: A literature review].
    Encephale 2016 Nov 18. Epub 2016 Nov 18.
    UVSQ, CESP, Inserm, université Paris-Saclay, université Paris-Sud, 94800 Villejuif, France; Département de psychiatrie, institut mutualiste Montsouris, 75014 Paris, France; Faculté de médecine, université Paris Descartes, 75006 Paris, France. Electronic address:
    Introduction: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Read More

    An atypical presentation of necrotising fasciitis.
    Ann R Coll Surg Engl 2017 Feb 21;99(2):e83-e84. Epub 2016 Nov 21.
    Medical Intensive Care Unit, University Hospital Leipzig , Germany.
    Necrotising fasciitis is a rare infection with a high mortality rate. Clinical manifestation may be influenced by an underlying disease state. We report a case of a 70-year-old man with an anaplastic large-cell lymphoma who presented with inconclusive signs of necrotising fasciitis following a neutropenic phase after chemotherapy. Read More

    Approach to evaluation of fever in ambulatory cancer patients receiving chemotherapy: A systematic review.
    Cancer Treat Rev 2016 Dec 1;51:35-45. Epub 2016 Nov 1.
    Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
    Purpose: To define the optimal model of care for patients receiving outpatient chemotherapy who experience a fever. Fever is a common symptom in patients receiving chemotherapy, but the approach to evaluation of fever is not standardized.

    Methods: We conducted a search for existing guidelines and a systematic review of the primary literature from database inception to November 2015. Read More

    Severe Agranulocytosis following Simultaneous Administration of Chlorpromazine and Trimethoprim-Sulfamethoxazole in a Patient with Sepsis: A Possible Toxic Combination.
    Case Rep Med 2016 18;2016:5653497. Epub 2016 Oct 18.
    Division of Critical Care and Pulmonology, Steward Carney Hospital, Tufts School of Medicine, Dorchester, MA, USA.
    Background. Chlorpromazine and trimethoprim-sulfamethoxazole (TMP/SMX) are two commonly prescribed medications by physicians. Either of those medications could cause fatal drug-induced agranulocytosis, with an unclear underlying mechanism. Read More

    The Porirua Protocol in the Treatment of Clozapine-Induced Gastrointestinal Hypomotility and Constipation: A Pre- and Post-Treatment Study.
    CNS Drugs 2017 Jan;31(1):75-85
    Pharmacy Department, Capital and Coast District Health Board, Private Bag 7902, Wellington South, New Zealand.
    Background: Clozapine, an antipsychotic used in treatment-resistant schizophrenia, causes slow gastrointestinal transit in 50-80% of patients. Clozapine-induced gastrointestinal hypomotility is both common and serious, and potential complications include severe constipation, ileus, bowel obstruction and related complications, with a higher mortality rate than clozapine-related agranulocytosis. Little evidence exists on its prevention and management. Read More

    A Multicenter Phase II Study of Twice-Weekly Bortezomib plus Rituximab in Patients with Relapsed Follicular Lymphoma: Long-Term Follow-Up.
    Acta Haematol 2017 4;137(1):7-14. Epub 2016 Nov 4.
    Program of Innovative Therapy in Oncology and Hematology, Department of Diagnostic, Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy.
    Single-agent bortezomib (B) has shown activity in heavily pretreated patients with relapsed/refractory indolent lymphoma. On the basis of these findings, we performed a phase II study of B combined with rituximab (R) in patients with relapsed follicular lymphoma (FL). Forty-five patients with fairly good prognostic profiles were enrolled from 2007 to 2011 and received a total of 6 cycles of the B+R combination. Read More

    Pharmacogenetics and Predictive Testing of Drug Hypersensitivity Reactions.
    Front Pharmacol 2016 21;7:396. Epub 2016 Oct 21.
    Institute of Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein Kiel, Germany.
    Adverse drug reactions adverse drug reaction (ADR) occur in approximately 17% of patients. Avoiding ADR is thus mandatory from both an ethical and an economic point of view. Whereas, pharmacogenetics changes of the pharmacokinetics may contribute to the explanation of some type A reactions, strong relationships of genetic markers has also been shown for drug hypersensitivity belonging to type B reactions. Read More

    Evidence for the use of pimavanserin in the treatment of Parkinson's disease psychosis.
    Ther Adv Neurol Disord 2016 Nov 3;9(6):462-473. Epub 2016 Oct 3.
    Department of Neurology, Weill Cornell Medical Center, New York, NY USA.
    Parkinson's disease (PD) is a progressive neurodegenerative disorder with both motor and nonmotor symptoms (NMS), leading to significant morbidity and caregiver burden. Psychosis is common but is under recognized by physicians. When present, it increases the patient's risk of hospitalization and nursing home placement and caregiver burden. Read More

    Case of Pediatric Bullous Systemic Lupus Erythematosus Treated with Intravenous Immunoglobulin.
    Pediatr Dermatol 2017 Jan 25;34(1):e54-e56. Epub 2016 Oct 25.
    Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
    This is a case report of a 16-year-old girl recently diagnosed with systemic lupus erythematosus (SLE) who presented with multiple blisters on the face, hands, arms, legs, trunk, and vaginal and oral mucosa. Skin biopsy was consistent with bullous SLE (BSLE). Dapsone is often the first-line treatment option for BSLE, but the patient's history of anemia and leukopenia and long-term immunosuppression requirement for her systemic symptoms raised concerns about dapsone and bone marrow toxicity, especially hemolytic anemia and agranulocytosis. Read More

    Clostridium tertium in neutropenic patients: case series at a cancer institute.
    Int J Infect Dis 2016 Oct 26;51:44-46. Epub 2016 Aug 26.
    Department of Internal Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL 33612-9416, USA. Electronic address:
    Objective: Clostridium tertium is considered an uncommon pathogen in humans, but is a cause of bacteremia in patients with underlying hematological malignancies and neutropenia. A case series highlighting 10 years of experience with C. tertium as a cause of bacteremia in this population is presented; the cases were seen at a National Cancer Institute designated cancer center. Read More

    [Dipyrone (metamizole) : Considerations on monitoring for early detection of agranulocytosis].
    Schmerz 2017 Feb;31(1):5-13
    Arzneimittelkommission der Deutschen Ärzteschaft, Berlin, Deutschland.
    Background: Dipyrone (metamizole) is a non-opioid analgesic commonly used in Germany, which can, in very rare cases, cause life-threatening agranulocytosis. The prescribing information calls for regular monitoring of the differential blood count in cases of long-term treatment. However, there is uncertainty about how this testing should be handled in practice. Read More

    Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis: A single-center, retrospective study of 70 patients.
    Medicine (Baltimore) 2016 Oct;95(42):e4974
    aDepartment of Internal Medicine, University Hospital of Limoges bFunctional unit of Clinical Research and Biostatistics, Limoges School of Medicine, Limoges Cedex, France.
    Although a glucocorticoid (GC)-sparing strategy is needed for patients with giant cell arteritis (GCA) suffering from refractory disease or serious treatment-related complications, evidence of efficacy in this setting of immunosuppressive drugs and biotherapies is lacking. Herein, we evaluated the GC-sparing effects and tolerability of addition of dapsone (DDS) to prednisone therapy in patients with GCA. We retrospectively assessed data on 18 GCA patients who received DDS as a first-line treatment (DDS-1 group) and 52 patients who received it as a second- or third-line treatment for refractory GCA, with or without excessive GC-related toxicity (DDS-2 group). Read More

    Rhabdomyolysis in Clozapine Overdose.
    Drug Saf Case Rep 2015 Dec;2(1)
    Department of Intensive Care Center and National Poisons Information Center, University Medical Center Utrecht, Utrecht, The Netherlands.
    Context: Clozapine is used for decennia for the treatment of schizophrenia. Agranulocytosis, diabetic ketoacidosis, gastrointestinal hypomotility, and myocarditis are well-known adverse effects of clozapine, which are sometimes life threatening. Here we report a case of rhabdomyolysis upon an acute overdose of clozapine. Read More

    Idiosyncratic Drug-Induced Severe Neutropenia and Agranulocytosis in Elderly Patients (≥75 years): A Monocentric Cohort Study of 61 Cases.
    Drugs Real World Outcomes 2016 Dec;3(4):393-399
    Department of Internal Medicine, Strasbourg University Hospitals, Strasbourg, France.
    Background: Little data is currently available in the literature on neutropenia and agranulocytosis in the elderly, and, to our knowledge, idiosyncratic drug-induced agranulocytosis is particularly poorly covered, or not at all.

    Objective: We herein describe the clinical picture and outcome of patients aged ≥75 years with established idiosyncratic drug-induced agranulocytosis.

    Patients And Methods: Data from 61 patients over 75 years old with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed. Read More

    Ziprosidone-Induced Transient Agranulocytosis; Delayed Onset of Cardiac Adverse Effects with Fingolimod; Telmisartan-Induced Myotoxicity; Severe Dilated Cardiomyopathy Induced by Adalimumab and Ustekinumab.
    Hosp Pharm 2015 Nov 19;50(10):855-858. Epub 2015 Nov 19.
    Chair and Clinical Professor, Department of Pharmacy Practice, Temple University School of Pharmacy , Philadelphia, Pennsylvania ; Clinical Advisor, Institute for Safe Medication Practices , Horsham, Pennsylvania.
    The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Read More

    Meropenem-Induced Neutropenia in a Neonate.
    J Pediatr Pharmacol Ther 2016 Jul-Aug;21(4):353-357
    Department of Pharmacy: Clinical and Administrative Sciences, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma.
    Postmarketing surveillance has associated meropenem with the development of hematologic abnormalities, including agranulocytosis, neutropenia, and leukopenia, but the exact incidence in children is unknown. The case describes a full-term, 26-day-old neonate admitted for a sepsis workup. She was found to have a blood culture positive for Enterobacter cloacae and suspected meningitis and was initiated on meropenem 40 mg/kg/dose intravenously every 8 hours. Read More

    Hydroxychloroquine-induced agranulocytosis in a patient with long-term rheumatoid arthritis.
    Eur J Rheumatol 2016 Jun 21;3(2):91-92. Epub 2015 Aug 21.
    Department of Rheumatology, Royal Surrey County Hospital, Guildford, United Kingdom.
    Agranulocytosis is a rare and little-known side effect of hydroxychloroquine use. This report describes the case of a 71-year-old woman with poorly controlled rheumatoid arthritis who developed agranulocytosis after several months of hydroxychloroquine therapy. She had been on several different disease-modifying antirheumatic drugs, including methotrexate and leflunomide, for her rheumatoid arthritis. Read More

    Third-Line Chemotherapy with Irinotecan plus 5-Fluorouracil in Caucasian Metastatic Gastric Cancer Patients.
    Oncology 2016 6;91(6):311-316. Epub 2016 Oct 6.
    Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
    Purpose: The aim of this study was to evaluate the activity of the combination of 5-fluorouracil/folinic acid and irinotecan (FOLFIRI) as third-line chemotherapy (CT) in metastatic gastric cancer (mGC) patients pretreated with platinum derivatives, fluoropyrimidines, and taxanes.

    Methods: We prospectively collected data of mGC patients treated with third-line FOLFIRI at our institution from 2009 to 2014. Eligible patients should be treated with a fluoropyrimidine-platinum first-line CT and a subsequent taxane-based second-line CT. Read More

    A review of the safety of clozapine during pregnancy and lactation.
    Arch Womens Ment Health 2017 Feb 4;20(1):1-9. Epub 2016 Oct 4.
    Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
    Clozapine is an antipsychotic used in the management of treatment-resistant schizophrenia. However, little is known about clozapine use during pregnancy and lactation, or its impact on the mother, foetus, and infant. This review aims to summarize the available literature on the safety of clozapine use during the perinatal period. Read More

    Antibiotic prophylaxis with teicoplanin on alternate days reduces rate of viridans sepsis and febrile neutropenia in pediatric patients with acute myeloid leukemia.
    Ann Hematol 2017 Jan 4;96(1):99-106. Epub 2016 Oct 4.
    St. Anna Kinderspital and Children's Cancer Research Institute, Department of Pediatrics, Medical University of Vienna, Kinderspitalgasse 6, 1090, Vienna, Austria.
    Intensive chemotherapy directed against acute myeloid leukemia of childhood is followed by profound neutropenia and high risk for bacterial and fungal infections, including viridans group streptococci as a common cause for gram-positive septicemia. Few retrospective studies have shown the efficacy of various antibiotic prophylactic regimens in children. We retrospectively studied 50 pediatric patients treated on the AML-BFM 2004 protocol between 2005 and 2015 at St. Read More

    Neuromyelitis optica spectrum disorder coinciding with hematological immune disease: A case report.
    Mult Scler Relat Disord 2016 Sep 8;9:101-3. Epub 2016 Jul 8.
    Department of Neurology, University of Rostock, Rostock, Germany.
    Introduction: Recently defined consensus criteria for the diagnosis of neuromyelitis optica spectrum disorders (NMOSD) allow establishing the diagnosis in patients without elevated AQP4-Ab and optic nerve involvement. According to the new extended definition, NMOSD is closely associated with extensive spinal cord inflammation occurring in the course of systemic autoimmune diseases as sarcoidosis or lupus erythematodes. NMOSD occurring in the course of hematological disease have not yet been reported in the literature. Read More

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