26,225 results match your criteria Agranulocytosis


LONG TERM MANAGEMENT OF GLYCOGEN STORAGE DISEASE TYPE 1B: A BRAZILIAN TERTIARY CENTER EXPERIENCE.

Arq Gastroenterol 2021 Jan-Mar;58(1):87-92

Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brasil.

Background: Glycogen storage disease (GSD) type 1b is a multisystemic disease in which immune and infectious complications are present, in addition to the well-known metabolic manifestations of GSD. Treatment with granulocyte-colony stimulating factor (G-CSF) is often indicated in the management of neutropenia and inflammatory bowel disease.

Objective: To report on the demographics, genotype, clinical presentation, management, and complications of pediatric patients with glycogen storage disease type 1b (GSD 1b), with special attention to immune-related complications. Read More

View Article and Full-Text PDF

Prevention of docetaxel-associated febrile neutropenia with primary granulocyte colony-stimulating factor in Chinese metastatic hormone-sensitive and castration-resistant prostate cancer patients.

Asia Pac J Clin Oncol 2021 Apr;17 Suppl 3:39-47

Department of Clinical Oncology, Tuen Mun Hospital, New Territories, Hong Kong.

Introduction: Asian prostate cancer (PC) patients are particularly susceptible to docetaxel-related febrile neutropenia (FN). We evaluated primary granulocyte colony-stimulating factor (GCSF) for preventing FN in Chinese patients with metastatic hormone-sensitive PC (mHSPC) and castration-resistant PC (mCRPC).

Patients And Methods: Data from two cohorts of 377 Chinese patients with mHSPC (100; 26. Read More

View Article and Full-Text PDF

Using a fingerstick test for haematological monitoring in patients treated with clozapine.

Ther Adv Psychopharmacol 2021 25;11:20451253211000865. Epub 2021 Mar 25.

Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK.

Background: Treatment with clozapine requires regular blood monitoring in order to minimise the risk of agranulocytosis. The demands on patients and clinicians associated with monitoring may be reduced by using point-of-care, as opposed to lab-based assessments. We assessed the utility of a device that can measure white blood cell (WBC) and neutrophil counts by capillary fingerstick blood. Read More

View Article and Full-Text PDF

HLA-DQB1 6672G>C (rs113332494) is associated with clozapine-induced neutropenia and agranulocytosis in individuals of European ancestry.

Transl Psychiatry 2021 Apr 12;11(1):214. Epub 2021 Apr 12.

Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.

The atypical antipsychotic clozapine is the only effective medication for treatment-resistant schizophrenia. However, it can also induce serious adverse drug reactions, including agranulocytosis and neutropenia. The mechanism by which it does so is largely unknown, but there is evidence for contributing genetic factors. Read More

View Article and Full-Text PDF

Management of thyroid disorders during the COVID-19 outbreak: a position statement from the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism (SBEM).

Arch Endocrinol Metab 2021 Apr 12. Epub 2021 Apr 12.

Departamento de Tireoide, Sociedade Brasileira de Endocrinologia e Metabologia, Rio de Janeiro, RJ, Brasil.

This position statement was prepared to guide endocrinologists on the best approach to managing thyroid disorders during the coronavirus disease (COVID-19) pandemic. The most frequent thyroid hormonal findings in patients with COVID-19, particularly in individuals with severe disease, are similar to those present in the non-thyroidal illness syndrome and require no intervention. Subacute thyroiditis has also been reported during COVID-19 infection. Read More

View Article and Full-Text PDF

Clozapine-Associated Leukopenia and Agranulocytosis in Western Cape, South Africa: A 3-Year Retrospective Cohort Study.

J Clin Psychopharmacol 2021 May-Jun 01;41(3):250-254

From the Division of Clinical Pharmacology, Department of Medicine.

Background: Clozapine may cause life-threatening hematological side effects (HSEs). Hematological side effect incidence data from Sub-Saharan Africa are lacking. Furthermore, clozapine reduces cellular immunity, and it is unknown whether clozapine is a risk factor for tuberculosis or whether HIV is a risk factor for developing HSEs. Read More

View Article and Full-Text PDF

[Risk factors for neutropenia of late newborns].

Zhongguo Dang Dai Er Ke Za Zhi 2021 Apr;23(4):375-380

Department of Neonatology, Xuzhou Central Hospital/Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou, Jiangsu 221009, China.

Objective: To study the risk factors and treatment for neutropenia of late newborns (NLN).

Methods: Related clinical data were collected from the preterm infants and critically ill neonates who were admitted to the neonatal intensive care unit from July 2019 to January 2020. A total of 46 newborns with a blood absolute neutrophil count (ANC) of < 1. Read More

View Article and Full-Text PDF

[Adequacy of the safety of metamizole and agranulocytosis].

Aten Primaria 2021 Apr 3;53(6):102047. Epub 2021 Apr 3.

Médico especialista en Medicina Familiar y Comunitaria, consulta de Fibromialgia, Unidad de Aparato Locomotor, Hospital de Denia, Alicante. Grupo de Fármacos de semFYC, Grupo de Investigación en Humanidades Histex, España. Electronic address:

Objective: To analyze whether the drug safety update issued by the Spanish Agency of Medicines and Healthcare Products (AEMPS), dated October 30, 2018, on agranulocytosis and metamizole contains accurate and necessary information to protect patients from the presentation of this adverse reaction (AR) and if the official documentation of medicines containing metamizole for doctors, pharmacists and the general population conforms to the guidelines of the AEMPS to reduce this risk.

Setting And Participants: Drug safety update, bibliographic search, information at the European Medicines Agency on metamizole drugs marketed in Spain, technical datasheets, leaflets, Bot PLUS Health Information Database and Catalog of Pharmaceutical Specialties. Notification of 4cases of agranulocytosis due to metamizole after the drug safety update was issued. Read More

View Article and Full-Text PDF

Prospective Multicenter Phase II Study of Biweekly TAS-102 and Bevacizumab for Metastatic Colorectal Cancer.

Anticancer Res 2021 Apr;41(4):2157-2163

Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.

Background: This study assessed the efficacy and safety of biweekly trifluridine and tipiracil hydrochloride (TAS-102) with bevacizumab combination therapy for patients with metastatic colorectal cancer (mCRC).

Patients And Methods: We included 19 patients with mCRC who received TAS-102 and bevacizumab combination therapy biweekly as third-line chemotherapy. The primary endpoint was progression-free survival. Read More

View Article and Full-Text PDF

Inhibitor of BRAF Mutation as a Treatment Option for Hairy Cell Leukemia With Deep Neutropenia and Infectious Complications.

Clin Lymphoma Myeloma Leuk 2021 Mar 3. Epub 2021 Mar 3.

National Research Center for Hematology, Moscow, Russia.

Standard therapy in hairy cell leukemia (HCL) is often impossible at the time of deep neutropenia/agranulocytosis with or without infectious complications; it is thus a complex therapeutic problem. Vemurafenib has been used to treat resistant HCL since 2012. Because vemurafenib does not have a myelotoxic effect, we thought that it could be used to treat HCL associated with deep neutropenia/agranulocytosis with or without the development of infectious complications as a preliminary stage before treatment with cladribine. Read More

View Article and Full-Text PDF

Randomized and dose-escalation trials of recombinant human serum albumin /granulocyte colony-stimulating factor in patients with breast cancer receiving anthracycline-containing chemotherapy.

BMC Cancer 2021 Mar 31;21(1):341. Epub 2021 Mar 31.

Department of Medical Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.

Background: To evaluate the efficacy and safety of recombinant human serum albumin /granulocyte colony-stimulating factor (rHSA/G-CSF) in breast cancer following receipt of cytotoxic agents.

Methods: The phase 1b trial assessed the pharmacokinetics, pharmacodynamics, and safety of dose-escalation, ranging from rHSA/G-CSF 1800 μg, 2100 μg, and 2400 μg. Randomized controlled phase 2b trial was further conducted to ensure the comparative efficacy and safety of rHSA/G-CSF 2400 μg and rhG-CSF 5 μg/kg. Read More

View Article and Full-Text PDF

Primary Prophylaxis of Febrile Neutropenia With Pegfilgrastim in Small-cell Lung Cancer Patients Receiving Amrubicin as Second-line Therapy.

Anticancer Res 2021 Mar;41(3):1615-1620

Department of Pharmacy, Gifu University Hospital, Gifu, Japan;

Background/aim: We evaluated the efficacy of primary prophylaxis with pegfilgrastim (PEG) for febrile neutropenia (FN) in small cell lung cancer (SCLC) patients receiving amrubicin (AMR).

Patients And Methods: A retrospective cohort study was conducted in patients with SCLC receiving AMR as second-line therapy.

Results: A total of 33 patients were treated with AMR (no PEG group), while 13 patients were treated with AMR plus prophylactic administration of PEG (PEG group). Read More

View Article and Full-Text PDF

Key Pathogenic Factors in Coronavirus Disease 2019-Associated Coagulopathy and Acute Lung Injury Highlighted in a Patient With Copresentation of Acute Myelocytic Leukemia: A Case Report.

A A Pract 2021 Mar 30;15(4):e01432. Epub 2021 Mar 30.

Departments of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, North Carolina.

The role of concurrent illness in coronavirus disease 2019 (COVID-19) is unknown. Patients with leukemia may display altered thromboinflammatory responses. We report a 53-year-old man presenting with acute leukemia and COVID-19 who developed thrombotic complications and acute respiratory distress syndrome. Read More

View Article and Full-Text PDF

Desensitization to Methimazole.

Endocr Pract 2021 Mar 15;27(3):185-190. Epub 2020 Dec 15.

Loyola University Medical Center, Maywood, Illinois.

Objective: Thionamides (methimazole and propylthiouracil) have been associated with common side effects, such as rash and pruritus, and rare but serious adverse effects, such as agranulocytosis and hepatotoxicity. Methimazole is usually the preferred thionamide for the treatment of hyperthyroidism if the patient is not planning to conceive or not in the first trimester of pregnancy, given the less frequent dosing and lower risk of hepatotoxicity. In patients who experience rash or itching when treated with methimazole, switching them to propylthiouracil is one treatment option. Read More

View Article and Full-Text PDF

Clozapine treatment: Ensuring ongoing monitoring during the COVID-19 pandemic.

Psychiatriki 2021 Mar 8. Epub 2021 Mar 8.

Department of Psychiatry, Aghioi Anargyroi Hospital, National and Kapodistrian University of Athens, Athens, Greece.

To the Editors, The current coronavirus pandemic (COVID-19) has led mental health systems to uncertainty regarding safe continuation of clozapine monitoring protocols. Clozapine is without doubt the only antipsychotic available with repeatedly proven efficacy in treatment resistant schizophrenia.1 Replacing clozapine with an alternative antipsychotic in patients stabilized with clozapine can potentially lead to higher risk of relapse or exacerbation of severity of illness. Read More

View Article and Full-Text PDF

Genotoxic and cytotoxic effects of the drug dipyrone sodium in African green monkey kidney (Vero) cell line exposed in vitro.

Naunyn Schmiedebergs Arch Pharmacol 2021 Mar 23. Epub 2021 Mar 23.

Laboratory of Human Cytogenetic, Institute of Biological Sciences, Federal University of Pará (UFPA), Av. Augusto Corrêa, 01, Belém, Pará, 66075-110, Brazil.

Dipyrone or metamizole is one of the most used analgesics, mainly due to its low financial cost. However, in some countries, the sale of dipyrone is prohibited due to reported severe cases of agranulocytosis as a result of its use. Despite its high use, studies showing genotoxic and cytotoxic effects of dipyrone in mammalian cells are scarce. Read More

View Article and Full-Text PDF

Interdisciplinary Safety Evaluation for Learning and Decision-Making.

Ther Innov Regul Sci 2021 Mar 17. Epub 2021 Mar 17.

Covilance, LLC, Belmont, CA, USA.

The FDA IND safety reporting Final Rule (21CFR 312.32) applies to all human drugs and biological products being studied under an Investigational New Drug (IND). A sponsor must file an IND safety report for any serious unexpected suspected adverse reaction (SUSAR) of a medicinal product being investigated. Read More

View Article and Full-Text PDF

Hematological immune related adverse events after treatment with immune checkpoint inhibitors.

Eur J Cancer 2021 Apr 9;147:170-181. Epub 2021 Mar 9.

Department of Dermatology, University Hospital Kiel, Kiel, Germany.

Introduction: With the increasing use of checkpoint inhibitors, rare immune-related adverse events (irAE) are being identified. Haematological irAE (hem-irAE) are difficult to treat and have shown high mortality rates. In order to improve side-effect management for these potentially life-threatening events, we analysed frequency, severity and outcomes. Read More

View Article and Full-Text PDF

COVID-19 infection causes a reduction in neutrophil counts in patients taking clozapine.

J Psychiatry Neurosci 2021 03 11;46(2):E232-E237. Epub 2021 Mar 11.

From the Pharmacy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom (Gee, Taylor); and the Institute of Pharmaceutical Sciences, King's College London, Franklin Wilkins Building, Stamford Street, London, United Kingdom (Gee, Taylor).

Background: Monitoring of white cell counts during clozapine treatment leads to cessation of therapy if levels fall below predetermined values. Reductions in white cell counts, driven by lower levels of lymphocytes, have been observed with coronavirus disease 2019 (COVID-19). Neutropenia during COVID-19 has not been reported. Read More

View Article and Full-Text PDF

Considerations of HLA, Renal Failure, Valproic Acid Use, and Current Treatment Guidelines in Clozapine-Induced Agranulocytosis.

Case Rep Psychiatry 2021 20;2021:8816390. Epub 2021 Feb 20.

Lake Erie College of Osteopathic Medicine, 1858 W Grandview Blvd, Erie, PA 16509, USA.

Clozapine, the choice atypical antipsychotic for refractory schizophrenia, schizoaffective disorder, and bipolar disorder, has been shown to reduce positive and negative symptoms of schizophrenia. Clozapine, though beneficial in reducing the need for hospitalization, rehabilitation, and health care costs, is known as a drug of last resort due to its potential adverse event of clozapine-induced agranulocytosis, which holds a case fatality rate between 4.2 and 16%. Read More

View Article and Full-Text PDF
February 2021

NAT2 polymorphisms as a cause of metamizole-induced agranulocytosis.

Pharmacogenet Genomics 2021 Mar 5. Epub 2021 Mar 5.

Department of Pediatrics III, Pediatric Hematology and Oncology, Cardiology, Pulmonology Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Germany.

Metamizole is a widely prescribed NSAID with excellent analgesic and antipyretic properties. Although very effective, it is banned in some countries because of the risk for severe agranulocytosis. We here describe three patients with metamizole-associated agranulocytosis. Read More

View Article and Full-Text PDF

Graves' disease in a five-month-old boy with an unusual treatment course.

J Pediatr Endocrinol Metab 2021 Mar 15;34(3):401-406. Epub 2020 Dec 15.

Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA.

Objectives: Graves' disease (GD) is rare in children under age five years. Antithyroid drugs are typically first-line therapy but carry the risks of agranulocytosis and liver dysfunction.

Case Presentation: A male infant with multiple congenital anomalies, left ventricular hypertrophy, and neurologic dysfunction developed GD at five months of life. Read More

View Article and Full-Text PDF

Meta-analysis: combination of meropenem vs ceftazidime and amikacin for empirical treatment of cancer patients with febrile neutropenia.

Medicine (Baltimore) 2021 Feb;100(8):e24883

Department of Neurology, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, PR China.

Background: Meropenem monotherapy vs ceftazidime plus amikacin have been approved for use against febrile neutropenia. To assess the effectiveness and safety of them for empirical treatment of cancer patients with febrile neutropenia, we conducted a meta-analysis of randomized controlled trial.

Methods: Randomized controlled trials on ceftazidime plus amikacin, or/and monotherapy with meropenem for the treatment of cancer patients with febrile neutropenia were identified by searching Cochrane Library, PubMed, Science Direct, Wiley Online, Science Citation Index, Google (scholar), National Center for Biotechnology Information, and China National Knowledge Infrastructure. Read More

View Article and Full-Text PDF
February 2021

Preoperative plasmapheresis in patients with Graves' disease intolerant to antithyroid drugs.

Ther Apher Dial 2021 Mar 4. Epub 2021 Mar 4.

Marmara University School of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey.

Antithyroid drugs (ATDs) are the mainstay of treatment for Graves' disease with possible detrimental adverse effects. Surgery or radioactive iodine (RAI) ablation is the second choice among the treatment options in cases of non-remission. Normalization of serum thyroid hormone levels as much as possible is required before surgery or RAI to prevent thyrotoxic crisis in patients with uncontrolled Graves' disease. Read More

View Article and Full-Text PDF

Oncologic immunomodulatory agents in patients with cancer and COVID-19.

Sci Rep 2021 03 1;11(1):4814. Epub 2021 Mar 1.

Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.

Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. It is unclear how these agents affect patients with cancer who are infected with SARS-CoV-2. We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure or death with receipt of the aforementioned medications and with pre-COVID-19 neutropenia. Read More

View Article and Full-Text PDF

Immune cytopenia after allogeneic haematopoietic stem-cell transplantation: challenges, approaches, and future directions.

Lancet Haematol 2021 Mar;8(3):e229-e239

Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland; Division of Hematology, University Hospital Basel, Basel, Switzerland. Electronic address:

Immune-mediated cytopenia after allogeneic haematopoietic stem-cell transplantation is rare. The pathophysiology of immune-mediated anaemia, thrombocytopenia, and neutropenia, which occur alone or in combination with other cytopenias, is unclear and most probably a consequence of immune dysregulation. Risk factors for this complication have been identified in retrospective studies but these should be interpreted with caution and should not be generalised to this heterogeneous patient population. Read More

View Article and Full-Text PDF

Acetazolamide-Induced Agranulocytosis in a Patient with Pseudotumor Cerebri.

Ann Indian Acad Neurol 2020 Sep-Oct;23(5):732-733. Epub 2020 Dec 8.

Division of Pediatric Neurology, Cukurova University Faculty of Medicine, Adana, Turkey.

View Article and Full-Text PDF
December 2020

Subcutaneous daratumumab in Asian patients with heavily pretreated multiple myeloma: subgroup analyses of the noninferiority, phase 3 COLUMBA study.

Ann Hematol 2021 Apr 18;100(4):1065-1077. Epub 2021 Feb 18.

Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.

The phase 3 COLUMBA study demonstrated noninferiority of subcutaneous daratumumab (DARA SC) to intravenous daratumumab (DARA IV) in relapsed or refractory multiple myeloma. We present a subgroup analysis of Asian patients from COLUMBA. Eligible patients had ≥ 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory drug, or were double refractory. Read More

View Article and Full-Text PDF

Hematologic autoimmune disorders in the course of COVID-19: a systematic review of reported cases.

Hematology 2021 Dec;26(1):225-239

Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran.

Objective: As COVID-19 is a new emerging disease, the hematological/immunological changes that develop in the infected patients remain unknown. This study aims to systematically review the hematologic autoimmune complications in these patients.

Method: Data from three online databases including Medline (via PubMed), Scopus and Web of Science were searched on 19 December 2020, and after excluding duplicate, irrelevant and inappropriate records, eligible documents were identified. Read More

View Article and Full-Text PDF
December 2021

Ceftriaxone-induced Agranulocytosis.

Eur J Case Rep Intern Med 2021 8;8(1):002215. Epub 2021 Jan 8.

Hospital de Santo Espírito da Ilha Terceira, Angra do Heroísmo, Portugal.

Ceftriaxone is a widely used antibiotic regarded as safe and effective. Drug-induced agranulocytosis is a life-threatening adverse reaction and few reports related to ceftriaxone were found in a review of the literature. The authors present a case of ceftriaxone-induced agranulocytosis, in which a brain abscess was diagnosed and ceftriaxone was commenced. Read More

View Article and Full-Text PDF
January 2021