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Incidental neutropenia: An emergency medicine focused approach.
Am J Emerg Med
December 2024
The University of Texas Southwestern Medical Center, Department of Emergency Medicine, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States.
Introduction: Neutropenia is defined as an absolute neutrophil count (ANC) < 1500 cells/microL and may be discovered incidentally in an asymptomatic, afebrile patient.
Objective: This narrative review provides an approach to the afebrile emergency department patient with incidental neutropenia.
Discussion: Neutropenia is an ANC < 1500 cells/microL, with mild neutropenia defined as an ANC ≥ 1000 to <1500 cells/microL, moderate ≥500 to <1000 cells/microL, severe <500 cells/microL, and agranulocytosis <200 cells/microL.
Literature review of the clinical features of sulfasalazine-induced drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DRESS/DIHS).
Front Pharmacol
December 2024
Department of Clinical Pharmacy, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), Xiangtan, China.
Background: Sulfasalazine (SSZ) is commonly prescribed for the treatment of ulcerative colitis, rheumatoid arthritis, and ankylosing spondylitis. However, it can also trigger a severe drug reaction known as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) or Drug-Induced Hypersensitivity Syndrome (DIHS). This article aims to analyze the clinical characteristics of DRESS/DIHS induced by SSZ and provide evidence for clinical diagnosis, treatment, and prevention.
View Article and Find Full Text PDFBupropion-induced pancytopenia.
BMJ Case Rep
November 2024
Division of Hematology, The University of British Columbia, Vancouver, British Columbia, Canada.
Bupropion is not a well established cause of medication-induced pancytopenia. In this report, we discuss a case of agranulocytosis, normocytic anemia and severe thrombocytopenia, with concurrent drug-induced rash within 3 weeks of bupropion initiation. Bone marrow biopsy demonstrated hypocellularity <10% without dysplastic features or increase in blast cells.
View Article and Find Full Text PDF[A rare medical chameleon with fatal consequences].
Inn Med (Heidelb)
November 2024
Medizinische Klinik, Evangelisches Krankenhaus Düsseldorf, Kirchfeldstraße 40, 40217, Düsseldorf, Deutschland.
The following case describes the relapsing and ultimately fatal outcome of DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome as an often misdiagnosed drug-induced hypersensitivity reaction. The disease was complicated by progressive worsening with involvement of multiple organs and profound agranulocytosis. The main goal of this article is to raise awareness of the syndrome and its potential severity.
View Article and Find Full Text PDFPharmacovigilance in Action: Utilizing VigiBase Data to Improve Clozapine Safety.
Patient Prefer Adherence
November 2024
Mental Health Research Center, Eastern State Hospital, Lexington, KY, USA.
Purpose: Clozapine is an antipsychotic which was approved in 1989 for treatment-resistant schizophrenia in the United States (US). There were few randomized trials before its approval and potentially lethal clozapine adverse drug reactions (ADRs), such as agranulocytosis and myocarditis were identified by pharmacovigilance. VigiBase, the WHO global database, is a cornerstone of international pharmacovigilance efforts for ADR identification during post-marketing surveillance.
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