Late-onset clozapine-induced agranulocytosis in a patient with comorbid multiple sclerosis

被引：7

作者：

Raveendranathan, Dhanya ^{[1
]}

Sharma, Eesha ^{[1
]}

Venkatasubramanian, Ganesan ^{[1
]}

Rao, Mukund G. ^{[1
]}

Varambally, Shivarama ^{[1
]}

Gangadhar, Bangalore N. ^{[1
]}

机构：

[1] Natl Inst Mental Hlth & Neurosci NIMHANS, Dept Psychiat, Bangalore 560029, Karnataka, India

来源：

GENERAL HOSPITAL PSYCHIATRY | 2013年 / 35卷 / 05期

关键词：

Clozapine; Agranulocytosis; Multiple sclerosis; NEUTROPENIA;

D O I：

10.1016/j.genhosppsych.2012.07.001

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

The risk of clozapine-induced agranulocytosis is highest in the initial 6 months after onset of treatment. There have been very few reports of neutropenia and agranulocytosis after this period. We report a unique case of delayed clozapine-induced agranulocytosis in a patient with preexisting multiple sclerosis (MS) which was treated with granulocyte colony-stimulating factor. Both MS and clozapine-induced agranulocytosis have an underlying autoimmune immune mechanism. This case highlights the need for frequent blood count monitoring on clozapine even after the initial 6 months of starting treatment especially in patients with a past history of drop in white blood cell counts as well as with a comorbid autoimmune disorder. (C) 2013 Elsevier Inc. All rights reserved.

引用

页码：574.e5 / 574.e6

页数：2

共 12 条

[1] Late-onset agranulocytosis in a patient with schizophrenia after 17 months of clozapine treatment
Bhanji, NH
Margolese, HC
Chouinard, G
Turnier, L
[J]. JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 2003, 23 (05) : 522 - 523
[2] Drew LRH, 2010, AUST NZ J PSYCHIAT, V44, P490, DOI [10.3109/00048671003610112, 10.3109/00048671003610120]
[3] N-DESMETHYLCLOZAPINE - A CLOZAPINE METABOLITE THAT SUPPRESSES HEMATOPOIESIS
GERSON, SL
ARCE, C
MELTZER, HY
[J]. BRITISH JOURNAL OF HAEMATOLOGY, 1994, 86 (03) : 555 - 561
[4] KANE J, 1988, ARCH GEN PSYCHIAT, V45, P789
[5] Lieberman Jeffrey A., 1992, Psychiatric Quarterly (New York), V63, P51, DOI 10.1007/BF01064682
[6] MA J, 1994, J CLIN PSYCHIAT, V55, P137
[7] PISCIOTTA AV, 1994, J CLIN PSYCHIAT, V55, P143
[8] Schulte Peter F J, 2010, Aust N Z J Psychiatry, V44, P1055, DOI 10.3109/00048674.2010.514859
[9] Clozapine-induced agranulocytosis after 11 years of treatment
Sedky, K
Shaughnessy, R
Hughes, T
Lippmann, S
[J]. AMERICAN JOURNAL OF PSYCHIATRY, 2005, 162 (04) : 814 - 814
[10] Late onset neutropenia during clozapine treatment
Tamam, L
Kulan, E
Ozpoyraz, N
[J]. PSYCHIATRY AND CLINICAL NEUROSCIENCES, 2001, 55 (05) : 547 - 548

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