27,826 results match your criteria Granulocytopenia

[Clozapine and agranulocytosis: Rethinking the usefulness of its monitoring].

Aten Primaria 2021 Jun 8;53(8):102114. Epub 2021 Jun 8.

Àrea del Medicament Servei Atenció Primària Muntanya, Institut Català de la Salut, Barcelona, España.

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Clozapine-associated neutropenia following augmentation with sodium valproate.

SAGE Open Med Case Rep 2021 30;9:2050313X211019791. Epub 2021 May 30.

Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Clozapine is gold standard for the management of treatment-resistant schizophrenia. It can offer life-changing symptom reduction where other antipsychotics have failed, and for these patients, treatment with clozapine should be maintained, if in any possible way. However, treatment with clozapine comes with a risk of developing potentially fatal adverse reactions, for example, severe neutropenia or agranulocytosis, in which case, treatment must be discontinued. Read More

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Prescription attitudes and practices regarding clozapine among Serbian psychiatrists: results of a nationwide survey.

Ther Adv Psychopharmacol 2021 29;11:20451253211020235. Epub 2021 May 29.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Objective: Despite clozapine being the most effective treatment for treatment-resistant schizophrenia (TRS), a clear explanation as to why it is underutilized and why its initiation is delayed remains unclear. The first aim of the study was to conduct a nation-wide assessment of both the psychiatrists' attitudes of the obstacles for prescribing clozapine as well as their prescription practices. The second aim was to make recommendations, based on the results obtained, for improving the Serbian clozapine guidelines. Read More

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Characteristics of voluntary reporting of adverse drug events related to antipsychotics in Australia: 14-year analysis.

Ther Adv Drug Saf 2021 29;12:20420986211012854. Epub 2021 May 29.

Paediatrician, Waverley Paediatrics, Glen Waverley, Victoria, Australia.

Background: Retrospective analyses of large databases of treated patients can provide useful links to the presence of drug misuse or rare and infrequent adverse effects, such as agranulocytosis, diabetic ketoacidosis or neuroleptic malignant syndrome. The aim of this study is to describe the adverse effects to antipsychotics reported in the Australian Database of Adverse Event Notifications (DAEN).

Methods: Data were collected from the DAEN - a spontaneous reporting database. Read More

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Lacosamide-induced sinus node dysfunction followed by severe agranulocytosis.

BMC Neurol 2021 Jun 8;21(1):217. Epub 2021 Jun 8.

Department of Neurology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, 371-8511, Gunma, Japan.

Background: Lacosamide (LCM) is the antiepileptic drug approved by the U.S. Food and Drug Administration in 2008 that facilitates slow activation of the voltage-gated sodium channels. Read More

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Neutropenia, Thrombocytopenia, and Eosinophilia: An Unusual Triad in a Patient on Long-Term Vancomycin Therapy.

Am J Case Rep 2021 Jun 8;22:e931647. Epub 2021 Jun 8.

School of Medicine, Saint Louis University, Saint Louis, MO, USA.

BACKGROUND Vancomycin is an antibiotic commonly used for management of severe gram-positive infections. It is infrequently associated with hematologic adverse effects, ranging from isolated thrombocytopenia or neutropenia to pancytopenia. Although the mechanism is poorly understood, it is considered an immune-mediated phenomenon. Read More

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What about regular hematological monitoring during clozapine treatment? A compliance analysis using the French health insurance database.

Expert Opin Drug Saf 2021 Jun 14:1-10. Epub 2021 Jun 14.

Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.

Background: The inherent risk of agranulocytosis associated with clozapine requires the realization of weekly white blood cell monitoring (WBCM) during the 18 first weeks of treatment. The aim of this study was to assess the compliance with WBCM during clozapine initiation for schizophrenia and Parkinson's disease (PD) subjects.

Research Design And Method: The analysis was conducted using SNDS data on a cohort of new users of clozapine in 2018. Read More

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Genetic risk of clozapine-induced leukopenia and neutropenia: a genome-wide association study.

Transl Psychiatry 2021 Jun 3;11(1):343. Epub 2021 Jun 3.

The Affiliated Hospital of Qingdao University & The Biomedical Sciences Institute of Qingdao University (Qingdao Branch of SJTU Bio-X Institutes), Qingdao University, Qingdao, 266003, PR China.

Background: Clozapine is considered to be the most effective antipsychotic medication for schizophrenia. However, it is associated with several adverse effects such as leukopenia, and the underlying mechanism has not yet been fully elucidated. The authors performed a genome-wide association study (GWAS) in a Chinese population to identify genetic markers for clozapine-induced leukopenia (CIL) and clozapine-induced neutropenia (CIN). Read More

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Real-world experience of ocrelizumab initiation in a diverse multiple sclerosis population.

Mult Scler Relat Disord 2021 May 19;53:103021. Epub 2021 May 19.

UConn Health Comprehensive Multiple Sclerosis Center, Department of Neurology, University of Connecticut School of Medicine, Farmington, CT 06030, United States; Division of Multiple Sclerosis and Translational Neuroimmunology, Department of Neurology, University of Connecticut School of Medicine, Farmington, CT 06030, United States. Electronic address:

Background: Ocrelizumab (OCR) is a humanized monoclonal antibody directed against CD20 positive B-lymphocytes. It was approved for use in 2017 by the U.S. Read More

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Felty syndrome: a case report.

J Med Case Rep 2021 May 27;15(1):273. Epub 2021 May 27.

Orange Regional Medical Center, Middletown, NY, USA.

Background: Felty syndrome is a rare manifestation of chronic rheumatoid arthritis in which patients develop extraarticular features of hepatosplenomegaly and neutropenia. The typical presentation of Felty syndrome is in Caucasians, females, and patients with long-standing rheumatoid arthritis of 10 or more years. This case report presents a patient with an early-onset and atypical demographic for Felty syndrome. Read More

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Silent existence of eosinopenia in sepsis: a systematic review and meta-analysis.

BMC Infect Dis 2021 May 24;21(1):471. Epub 2021 May 24.

Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Background: Sepsis is a life-threatening and time-critical medical emergency; therefore, the early diagnosis of sepsis is essential to timely treatment and favorable outcomes for patients susceptible to sepsis. Eosinopenia has been identified as a potential biomarker of sepsis in the past decade. However, its clinical application progress is slow and its recognition is low. Read More

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Risk mitigation with the use of clozapine - Quo vadimus.

Asian J Psychiatr 2021 Jul 19;61:102693. Epub 2021 May 19.

National Institute of Mental Health and Neurosciences, India.

The risk of neutropenia decreases significantly after the first year of clozapine initiation, and indefinite hematological monitoring is increasingly questioned. Despite comparable risks of neutropenia, the guidelines for antithyroid drugs - carbimazole and propylthiouracil do not recommend routine hematological monitoring. Assuming a similar pathogenic mechanism, data from antithyroid drugs indicate that neutropenia develops rapidly, and indefinite hematological monitoring misses a large majority of cases in the pre-symptomatic phase. Read More

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Incidence and Clinical Outcomes of Febrile Neutropenia in Adult Cancer Patients with Chemotherapy Using Korean Nationwide Health Insurance Database.

Yonsei Med J 2021 Jun;62(6):479-486

Division of Oncology-Hematology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

Purpose: The aim of this study was to evaluate the episodes of febrile neutropenia (FN) in patients with gastric cancer (GC), colorectal cancer (CRC), lung cancer (LC), and breast cancer (BC); and to identify the incidence and trends of admission rates, as well as factors affecting mortality.

Materials And Methods: Using nationwide claims data, all new admissions to hospitals for FN were selected. We evaluated the incidence of FN and mortality-related clinical factors in adult cancer patients who received cytotoxic chemotherapy from January 2004 to December 2013. Read More

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Circumventing Mutation to Nix Neutropenia.

Julia Skokowa

N Engl J Med 2021 May;384(20):1956-1958

From the Department of Oncology, Hematology, Clinical Immunology, and Rheumatology, University Hospital Tübingen, Tübingen, Germany.

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A 25-Year-Old Man with Refractory Schizophrenia and Clozapine-Induced Myocarditis Diagnosed by Non-Invasive Cardiovascular Magnetic Resonance.

Am J Case Rep 2021 May 15;22:e930103. Epub 2021 May 15.

Department of Cardiology, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

BACKGROUND Clozapine, a second-generation antipsychotic, is often prescribed for refractory schizophrenia; however, it can cause life-threatening adverse events including agranulocytosis and myocarditis. Making the diagnosis of clozapine-induced myocarditis can be challenging given the non-specific presentation as well as risk involved in obtaining an endomyocardial biopsy. As clozapine-induced myocarditis carries a mortality risk of up to 30%, timely recognition, diagnosis, and management are vital. Read More

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High silver concentrations in biological samples following different exposures: Two case reports.

J Trace Elem Med Biol 2021 Sep 7;67:126775. Epub 2021 May 7.

Centre anti-poison-toxicovigilance, CHU Angers, France.

Background: Silver is used in various industrial applications, but also in confectioneries and for therapeutic use due to its antibiotic properties. Its toxicity is not well documented and most often only in the context of professional exposure.

Aim: Here we report two cases of high silver concentrations in biological samples in two women: the first patient presented grey marks around her cuticles, probably due to her consumption of silvered sweets and the second patient presented agranulocytosis and thrombocytopenia occurring within 24 h after the topical application of a cream containing sulfadiazine and silver to burns over a large surface area. Read More

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September 2021

Delayed, transient and self-resolving neutropenia following COVID-19 pneumonia.

BMJ Case Rep 2021 May 12;14(5). Epub 2021 May 12.

Rheumatology, Tripler Army Medical Center, Honolulu, Hawaii, USA.

A novel coronaravirus, identified as SARS-CoV-2, spread throughout the world in 2020. The COVID-19 pandemic has led to many discoveries and clinical manifestations. A young patient is presented with new, self-resolving neutropenia presenting weeks after a prolonged hospital stay for COVID-19 pneumonia. Read More

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Vemurafenib plus Rituximab in Refractory or Relapsed Hairy-Cell Leukemia.

N Engl J Med 2021 05;384(19):1810-1823

From the Institute of Hematology, Ospedale S. Maria della Misericordia, and the Department of Medicine, University of Perugia, Perugia (E.T., L.D.C., E.S., M.C., S.A., V.M.P., B.F.), the Department of Medicine, Section of Hematology, University of Verona, Verona (A. Ambrosetti), the Hematology Unit, Ospedale di Cosenza, Cosenza (E.L.), the Hematology Unit, Department of Transfusional Medicine-SIMMT, Maria Paternò-Arezzo Hospital, Ragusa (A. Antolino), the Hematology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome (A.P., R.F.), and the Hematology and Stem Cell Transplant Unit, A.O. San Camillo Forlanini (L.R.), Rome, the Department of Hematology, Spedali Civili di Brescia, Brescia (S.F.), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (P.L.Z.), the Department of Translational Medicine, Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara (G.G.), the Hematology Unit, Ospedale di Carrara, Carrara (R.D.S.), the Hematology Unit, Ospedale di Frosinone, Frosinone (N.F.), the Hematology Unit, Ospedale di Ronciglione, Viterbo (P.F.), the Hematology Unit, Ospedale di Pesaro, Pesaro (G.V.), and the Hematology Unit, Azienda Sanitaria Universitaria Integrata-Ospedale Maggiore, Trieste (F.Z.) - all in Italy.

Background: Hairy-cell leukemia (HCL) is a CD20+ indolent B-cell cancer in which a BRAF V600E kinase-activating mutation plays a pathogenetic role. In clinical trials involving patients with refractory or relapsed HCL, the targeting of BRAF V600E with the oral BRAF inhibitor vemurafenib led to a response in 91% of the patients; 35% of the patients had a complete response. However, the median relapse-free survival was only 9 months after treatment was stopped. Read More

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Effect of 3 mg versus 6 mg pegfilgrastim on the prevention of febrile neutropenia in breast cancer patients receiving docetaxel and cyclophosphamide: a retrospective study.

Ann Palliat Med 2021 May 28;10(5):5310-5315. Epub 2021 Apr 28.

Department of Pharmacy, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

Background: An ECCOPG (Eastern China Cooperative Oncology Pharmacy Group) funded study was designed to compare the effect of 3 versus 6 mg pegfilgrastim for primary prevention of febrile neutropenia (FN) in Chinese breast cancer patients retrospectively.

Methods: Patients undergoing a docetaxel and cyclophosphamide chemotherapy regimen, followed by pegfilgrastim, for primary prevention during 2018 and 2020 were retrospectively enrolled in the present study. The patients were divided into 2 groups according to the dose of pegfilgrastim. Read More

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Thrombocytopenia and agranulocytosis in a FXTAS choreic patient treated with tetrabenazine.

Neurol Sci 2021 May 10. Epub 2021 May 10.

Service de Neurologie, APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris, Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France.

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Neutrophil elastase: Nonsense lost in translation.

Cell Stem Cell 2021 05;28(5):790-792

Institute for Stem Cell and Regenerative Medicine, Department of Laboratory Medicine & Pathology, University of Washington School of Medicine, Seattle, WA 98109, USA. Electronic address:

In this issue of Cell Stem Cell, Daniel Bauer and colleagues investigate the pathogenesis of ELANE-associated severe congenital neutropenia (SCN) and describe two potentially universal gene correction strategies for autosomal dominant disorders (Rao et al., 2021). One exploits nonsense-mediated decay to prevent translation of the mutant allele. Read More

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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

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Ibrutinib combined with venetoclax for the treatment of relapsed/refractory diffuse large B cell lymphoma.

Ann Hematol 2021 Jun 26;100(6):1509-1516. Epub 2021 Apr 26.

Department of Oncology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou, China.

Treatment outcomes of relapsed/refractory diffuse large B cell lymphoma (R/R DLBCL) are far from satisfactory. Certain efficacy of ibrutinib has been observed in non-GCB subtype DLBCL patients. This study aimed to investigate the efficacy and safety of ibrutinib plus BCL2 inhibitor venetoclax in R/R DLBCL patients with non-GCB subtype and BCL2 overexpression. Read More

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The impact of chemotherapy-induced neutropenia on the outcome of direct-to-implant immediate breast reconstruction.

Ann Palliat Med 2021 May 14;10(5):5181-5187. Epub 2021 Apr 14.

Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Background: Adjuvant chemotherapy can cause neutropenia by inhibition of hematopoiesis. However, little information is known about the effects of chemotherapy-induced neutropenia (CIN) on the outcomes of direct-to-implant (DTI) immediate breast reconstruction after skin-sparing mastectomy.

Methods: A retrospective review was performed for all patients with DTI immediate breast reconstruction after skin-sparing mastectomy (n=372) between January 2011 and December 2019. Read More

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iPSC modeling of stage-specific leukemogenesis reveals BAALC as a key oncogene in severe congenital neutropenia.

Cell Stem Cell 2021 05 23;28(5):906-922.e6. Epub 2021 Apr 23.

Department of Oncology, Hematology, Immunology, and Rheumatology, University Hospital Tuebingen, 72074 Tuebingen, Germany. Electronic address:

Severe congenital neutropenia (CN) is a pre-leukemic bone marrow failure syndrome that can evolve to acute myeloid leukemia (AML). Mutations in CSF3R and RUNX1 are frequently observed in CN patients, although how they drive the transition from CN to AML (CN/AML) is unclear. Here we establish a model of stepwise leukemogenesis in CN/AML using CRISPR-Cas9 gene editing of CN patient-derived iPSCs. Read More

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Febrile neutropenia due to COVID-19 in an immunocompetent patient.

BMJ Case Rep 2021 Apr 23;14(4). Epub 2021 Apr 23.

Department of Medical Oncology Haematology, All India Institute of Medical Sciences-Rishikesh, Rishikesh, Uttarakhand, India.

While lymphopenia has been a common finding in COVID-19 infection, particularly in severe cases, febrile neutropenia has been very rarely reported in immunocompetent patients with COVID-19. Herein, we report the case of a 76-year-old hypertensive and diabetic man who was hospitalised with severe COVID-19 infection and developed delayed-onset severe neutropenia with neutropenic fever, which responded to treatment with antibiotics and granulocyte colony-stimulating factor. This case highlights the importance of identifying a rare complication (febrile neutropenia on the fifth week) of COVID-19 infection in hospitalised patients by intensive monitoring and aggressive management for favourable outcomes. Read More

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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

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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

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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

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