Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients
Agranulocytosis is a rare, but serious and life-threatening hematologic disorder in elderly patients. Idiosyncratic drug-induced agranulocytosis (IDIA) has been classically defined by a neutrophil count below 0.5 × 10<sup>9</sup>/L. The annual incidence of IDIA in Europe is about 1.6–9.2...
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doaj-1db8617ca7364bc281ff10d1b34d5c662020-11-25T03:10:58ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0191808180810.3390/jcm9061808Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly PatientsNoel Lorenzo-Villalba0Maria Belen Alonso-Ortiz1Yasmine Maouche2Abrar-Ahmad Zulfiqar3Emmanuel Andrès4Service de Médecine Interne, Diabètes et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceServicio de Medicina Interna, Hospital Universitario de Gran Canaria Dr Negrin, 35000 Las Palmas de Gran Canaria, SpainService de Médecine Interne, Diabètes et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceService de Médecine Interne, Diabètes et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceService de Médecine Interne, Diabètes et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceAgranulocytosis is a rare, but serious and life-threatening hematologic disorder in elderly patients. Idiosyncratic drug-induced agranulocytosis (IDIA) has been classically defined by a neutrophil count below 0.5 × 10<sup>9</sup>/L. The annual incidence of IDIA in Europe is about 1.6–9.2 cases per million inhabitants. Increasing age and female sex have been considered as risk factors for the development of this condition. Besides, it is well known that older people take on average more drugs than younger people. This condition is most often associated with the intake of antibacterial agents, antiplatelets, antithyroids, antipsychotics, antiepileptics and nonsteroidal anti-inflammatory drugs (NSAIDs). Initially, agranulocytosis may present without symptoms, but may quickly progress to a severe infection and sepsis. The causative drug should be immediately stopped. In febrile patients, blood cultures and where indicated, site-specific cultures should be obtained and early treatment with empirical broad-spectrum antibiotics started. Even with adequate treatment, the mortality rate is higher in elderly patients reaching up to 20%. Hematopoietic growth factors have proven to be useful as they shorten the duration of neutropenia. However, data on neutropenia and agranulocytosis in the elderly meeting the criteria of evidence-based medicine are still poor in the literature. This review analyzes the results of our experience as well as other published studies of the universal literature.https://www.mdpi.com/2077-0383/9/6/1808agranulocytosisdrug-induced agranulocytosisidiosyncratic agranulocytosisneutropeniaelderly patientsnon-chemotherapy drugs |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Noel Lorenzo-Villalba Maria Belen Alonso-Ortiz Yasmine Maouche Abrar-Ahmad Zulfiqar Emmanuel Andrès |
spellingShingle |
Noel Lorenzo-Villalba Maria Belen Alonso-Ortiz Yasmine Maouche Abrar-Ahmad Zulfiqar Emmanuel Andrès Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients Journal of Clinical Medicine agranulocytosis drug-induced agranulocytosis idiosyncratic agranulocytosis neutropenia elderly patients non-chemotherapy drugs |
author_facet |
Noel Lorenzo-Villalba Maria Belen Alonso-Ortiz Yasmine Maouche Abrar-Ahmad Zulfiqar Emmanuel Andrès |
author_sort |
Noel Lorenzo-Villalba |
title |
Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients |
title_short |
Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients |
title_full |
Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients |
title_fullStr |
Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients |
title_full_unstemmed |
Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients |
title_sort |
idiosyncratic drug-induced neutropenia and agranulocytosis in elderly patients |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-06-01 |
description |
Agranulocytosis is a rare, but serious and life-threatening hematologic disorder in elderly patients. Idiosyncratic drug-induced agranulocytosis (IDIA) has been classically defined by a neutrophil count below 0.5 × 10<sup>9</sup>/L. The annual incidence of IDIA in Europe is about 1.6–9.2 cases per million inhabitants. Increasing age and female sex have been considered as risk factors for the development of this condition. Besides, it is well known that older people take on average more drugs than younger people. This condition is most often associated with the intake of antibacterial agents, antiplatelets, antithyroids, antipsychotics, antiepileptics and nonsteroidal anti-inflammatory drugs (NSAIDs). Initially, agranulocytosis may present without symptoms, but may quickly progress to a severe infection and sepsis. The causative drug should be immediately stopped. In febrile patients, blood cultures and where indicated, site-specific cultures should be obtained and early treatment with empirical broad-spectrum antibiotics started. Even with adequate treatment, the mortality rate is higher in elderly patients reaching up to 20%. Hematopoietic growth factors have proven to be useful as they shorten the duration of neutropenia. However, data on neutropenia and agranulocytosis in the elderly meeting the criteria of evidence-based medicine are still poor in the literature. This review analyzes the results of our experience as well as other published studies of the universal literature. |
topic |
agranulocytosis drug-induced agranulocytosis idiosyncratic agranulocytosis neutropenia elderly patients non-chemotherapy drugs |
url |
https://www.mdpi.com/2077-0383/9/6/1808 |
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