Idiosyncratic Drug-Induced Severe Neutropenia and Agranulocytosis: State of the Art

In this chapter, we report and discuss the diagnosis and management of idiosyncratic drug-induced, or drug-associated, severe neutropenia, and agranulocytosis (neutrophil count of <0.5 × 109/L). In this setting, neutropenia remains a potentially serious adverse event due to the frequency of sever...

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Main Authors: Andrès, Emmanuel (Author), Mourot-Cottet, Rachel (Author)
Format: Ebooks
Published: IntechOpen, 2018-06-27.
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Summary:In this chapter, we report and discuss the diagnosis and management of idiosyncratic drug-induced, or drug-associated, severe neutropenia, and agranulocytosis (neutrophil count of <0.5 × 109/L). In this setting, neutropenia remains a potentially serious adverse event due to the frequency of severe sepsis, with severe deep tissue infections (e.g., pneumonia), life-threatening infections, septicemia, and septic shock in two-thirds of all hospitalized patients. Recently, several poor prognostic factors, impacting the hematological recovery, the duration of hospitalization, and the outcome have been identified that may be helpful when identifying "frailty" patients. These factors include: old age, poor performance status, septicemia or shock, comorbidities such as renal failure, and a neutrophil count below 0.1 × 109/L. recovery. In this situation, modern management, with broad-spectrum antibiotics in case of any sepsis sign and hematopoietic growth factors (HGF) (particularly G-CSF), is likely to improve the prognosis, with a current mortality rate around 5%.
Item Description:https://mts.intechopen.com/articles/show/title/idiosyncratic-drug-induced-severe-neutropenia-and-agranulocytosis-state-of-the-art