Phenytoin-induced agranulocytosis: a nonimmunologic idiosyncratic reaction?

Abstract:

:Agranulocytosis is a rare side effect of phenytoin treatment. We describe the case of an elderly man who developed agranulocytosis 2 weeks following initiation of phenytoin treatment, on no cytotoxic drugs or any other medications except decadron. The white blood cell count was 300/mm3 with absent granulocytes. The liver enzymes were also noted to be newly elevated. Complete workup showed no evidence of infection. The patient was managed as a case of neutropenic fever and phenytoin was discontinued. A bone marrow biopsy showed absent granulocyte precursors after myelocytes, and an antigranulocyte antibody titer was negative, which suggests a direct toxic effect rather than an immunologic phenomenon. Both agranulocytosis and hepatitis were readily reversible on phenytoin cessation.

journal_name

Acta Haematol

journal_title

Acta haematologica

authors

Sharafuddin MJ,Spanheimer RG,McClune GL

doi

10.1159/000204838

subject

Has Abstract

pub_date

1991-01-01 00:00:00

pages

212-3

issue

4

eissn

0001-5792

issn

1421-9662

journal_volume

86

pub_type

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