Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but Dangerous
Drug-induced agranulocytosis is a life-threatening side effect that usually manifests as a severe form of neutropenia associated with fever or signs of sepsis. It can occur as a problem in the context of therapy with a wide variety of drug classes. Numerous drugs are capable of triggering the rare i...
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doaj-3358db689ca945bcab7c63f327dc6c912021-08-13T06:46:16ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-08-011210.3389/fphar.2021.727717727717Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but DangerousBernd RattayRalf A. BenndorfDrug-induced agranulocytosis is a life-threatening side effect that usually manifests as a severe form of neutropenia associated with fever or signs of sepsis. It can occur as a problem in the context of therapy with a wide variety of drug classes. Numerous drugs are capable of triggering the rare idiosyncratic form of agranulocytosis, which, unlike agranulocytosis induced by cytotoxic drugs in cancer chemotherapy, is characterised by “bizzare” type B or hypersensitivity reactions, poor predictability and a mainly low incidence. The idiosyncratic reactions are thought to be initiated by chemically reactive drugs or reactive metabolites that react with proteins and may subsequently elicit an immune response, particularly directed against neutrophils and their precursors. Cells or organs that exhibit specific metabolic and biotransformation activity are therefore frequently affected. In this review, we provide an update on the understanding of drug-induced idiosyncratic agranulocytosis. Using important triggering drugs as examples, we will summarise and discuss the chemical, the biotransformation-related, the mechanistic and the therapeutic basis of this clinically relevant and undesirable side effect.https://www.frontiersin.org/articles/10.3389/fphar.2021.727717/fullidiosyncratic agranulocytosisadverse drug reactiondrug therapy safety managementagranulocytosis triggering drugsagranulocytosis incidence |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bernd Rattay Ralf A. Benndorf |
spellingShingle |
Bernd Rattay Ralf A. Benndorf Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but Dangerous Frontiers in Pharmacology idiosyncratic agranulocytosis adverse drug reaction drug therapy safety management agranulocytosis triggering drugs agranulocytosis incidence |
author_facet |
Bernd Rattay Ralf A. Benndorf |
author_sort |
Bernd Rattay |
title |
Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but Dangerous |
title_short |
Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but Dangerous |
title_full |
Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but Dangerous |
title_fullStr |
Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but Dangerous |
title_full_unstemmed |
Drug-Induced Idiosyncratic Agranulocytosis - Infrequent but Dangerous |
title_sort |
drug-induced idiosyncratic agranulocytosis - infrequent but dangerous |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pharmacology |
issn |
1663-9812 |
publishDate |
2021-08-01 |
description |
Drug-induced agranulocytosis is a life-threatening side effect that usually manifests as a severe form of neutropenia associated with fever or signs of sepsis. It can occur as a problem in the context of therapy with a wide variety of drug classes. Numerous drugs are capable of triggering the rare idiosyncratic form of agranulocytosis, which, unlike agranulocytosis induced by cytotoxic drugs in cancer chemotherapy, is characterised by “bizzare” type B or hypersensitivity reactions, poor predictability and a mainly low incidence. The idiosyncratic reactions are thought to be initiated by chemically reactive drugs or reactive metabolites that react with proteins and may subsequently elicit an immune response, particularly directed against neutrophils and their precursors. Cells or organs that exhibit specific metabolic and biotransformation activity are therefore frequently affected. In this review, we provide an update on the understanding of drug-induced idiosyncratic agranulocytosis. Using important triggering drugs as examples, we will summarise and discuss the chemical, the biotransformation-related, the mechanistic and the therapeutic basis of this clinically relevant and undesirable side effect. |
topic |
idiosyncratic agranulocytosis adverse drug reaction drug therapy safety management agranulocytosis triggering drugs agranulocytosis incidence |
url |
https://www.frontiersin.org/articles/10.3389/fphar.2021.727717/full |
work_keys_str_mv |
AT berndrattay druginducedidiosyncraticagranulocytosisinfrequentbutdangerous AT ralfabenndorf druginducedidiosyncraticagranulocytosisinfrequentbutdangerous |
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