DRUG-INDUCED AGRANULOCYTOSIS

A very large number of drugs can cause granulocytopenia with the resulting susceptibility to bacterial infections. The drug group with the highest incidence of agranulocytosis is that of the thyrostatics; the disorder follows in 1-3% of person treated with thiouracil and methimazole; in a pediatric patient group as high as 26% of treated children developed a leukopenia and 18% had granulocytopenia after taking propylthiouracil. Agranulocytosis has frequently been observed after ingestion of pyrazolone and phenothiazine. Ulcerations and necrotic lesions of the lips, oral mucosa and tonsils are prominent clinical manifestations of agranulocytosis. The bone marrow shows a large number of promyelocytes. Other medications that produce agranulocytosis and other blood dyscrasias are phenylbutazone, drugs of the aminopyrine type, and other compounds.