Drug-induced Blood Dyscrasias in Sweden

Böttiger, L. E.; Westerholm, B

doi:10.1136/bmj.3.5875.339

Cited by 149 publications

(43 citation statements)

References 9 publications

(1 reference statement)

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“…That rate can be contrasted with an incidence of 3.4 per million per year (range ϭ 1.5-5.5) in the eight regions that participated in the IAAAS. 8 As has been reported in numerous studies, [18][19][20][21][22][23][24][25][26] the disease occurs more commonly in women, and the incidence increases with age: below the age of 15 years there were no cases, whereas at ages Ն 60 years the incidence was 3.4 per million per year.…”

Section: Discussionmentioning

confidence: 57%

Agranulocytosis in Bangkok, Thailand: a predominantly drug-induced disease with an unusually low incidence. Aplastic Anemia Study Group.

Shapiro

Issaragrisil²,

Kaufman³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Agranulocytosis, a syndrome characterized by a marked reduction in circulating granulocytes, is strongly associated with medical drug use in Europe and the United States. Unregulated use of common pharmaceutical agents in developing countries has been suspected of causing large numbers of cases of agranulocytosis and deaths, especially among children. To elucidate the incidence and etiology of agranulocytosis in Thailand, a population-based casecontrol study of symptomatic agranulocytosis that resulted in hospital admission was conducted in Bangkok from 1990 to 1994. An attempt was also made to study the disease in Khonkaen (in northeastern Thailand) and Songkla (in southern Thailand), but there were insufficient cases in the latter regions, and the analysis was confined to subjects from Bangkok. In that region, the overall incidence of agranulocytosis was 0.8 per million per year; there were no deaths. As expected, the incidence was higher in females (0.9 per million), and it increased with age (4.3 per million beyond age 60). Among 25 cases and 529 controls the relative risk estimate for a combined category of all suspect drugs was 9.2 (95% confidence interval ϭ 3.9-21), and the proportion of cases that could be attributed to drug use was 68%. For individual drugs and drug classes the data were sparse; within these limitations, the strongest association appeared to be with antithyroid drugs. One case and three controls were exposed to dipyrone, a drug known to cause agranulocytosis; with such scanty data the risk could not be evaluated. Exposure to pesticides or solvents was not associated with an increased risk. This is the first formal epidemiologic study of agranulocytosis in a developing country. As in the West, most cases are attributable to medical drug use. However, the incidence of agranulocytosis in Bangkok, and apparently, in Thailand as a whole, is unusually low, and the disease does not pose a public health risk.

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Section: Discussionmentioning

confidence: 57%

Agranulocytosis in Bangkok, Thailand: a predominantly drug-induced disease with an unusually low incidence. Aplastic Anemia Study Group.

Shapiro

Issaragrisil²,

Kaufman³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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“…Discussion Neutropenia and thrombocytopenia are common blood disorders induced by (.3 lactam antibiotics (12). These complications are believed to be caused by an immunological reaction (13), but there remains a possibility that a direct toxic effect of Q-lactam anti biotics on the bone marrow is involved. Murphy et al (14) suggested that an immune mechanism similar to the well-recognized penicillin-induced immune haemolytic anemia was involved in both penicillin induced neutropenia and thrombocytopenia from the observation that a complement fixing IgG penicillin antibody reacted with granulocytes and platelets of a patient in the presence of the drugs.…”

Section: Resultsmentioning

confidence: 99%

Suppressive effect of antibiotics on colony formation from human megakaryocyte progenitors (CFU-M) and granulocyte-macrophage progenitors (CFU-GM).

1987

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Abstract-R-Lactamantibiotics, moxalactam (LMOX), cefotaxime (CTX), flomoxef (FMOX), cefamandole (CMD), carbenicillin (CBPC) and sulbenicillin (SBPC), suppressed colony formation from human megakaryocyte progenitors (CFU-M) and granulocyte-macrophage progenitors (CFU-GM) dose-dependently. The suppres sive potencies for both progenitors were weakest for CBPC and SBPC, moderate for LMOX and FMOX, and strongest for CMD and CTX. The stainability of glyco protein Ilb/Illa complex in the megakaryocyte colonies by the monoclonal antibody was decreased by LMOX and CTX. These data suggest that /3-lactam antibiotics directly suppress proliferation of CFU-M and CFU-GM.

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“…Our results show that the total dose of quinine excreted in breast milk will usually be less than 2-3 mg day-1. Hypersensitivity reactions such as thrombocytopenia (Bottiger & Westerholm, 1973) could be triggered by such doses.…”

Section: Discussionmentioning

confidence: 99%

Quinine pharmacokinetics and toxicity in pregnant and lactating women with falciparum malaria.

Phillips¹,

Looareesuwan²,

White³

et al. 1986

Brit J Clinical Pharma

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1 Quinine dihydrochloride (10 mg or, in two patients, a loading dose of 20 mg kg-) was infused intravenously over 4 h in ten severely ill but conscious women with falciparum malaria complicating the third trimester of pregnancy. 2 Plasma quinine concentrations, measured spectrophotofluorimetrically after benzene extraction, fitted closely a single exponential decline after the intravenous infusion. These data were therefore fitted to a one compartment model: total apparent volume of distribution, V, 0.96 + 0.271 kg-' (+ s.d.), elimination half-time (t112,z), 11.3 ± 4.3 h, total clearance, 1.22 + 0.77 ml min7l kg-. There was no relationship between arterial blood pressure and plasma quinine concentrations. 3 Eight women delivered of live infants while taking quinine, had placental cord plasma quinine concentrations from 1.0 to 4.6 mg 1-1 (mean 2.4) which correlated significantly with maternal plasma quinine concentrations (r = 0.78, t = 3.06, P < 0.05). The mean (+ s.d.) ratio of cord plasma to maternal plasma quinine concentration was 0.32 + 0.14.Heart blood from a foetus aborted at term had a plasma quinine concentration of 2.8 mg 171; simultaneous maternal plasma quinine was 7.1 mg 1-1 (ratio 0.39). 4 Breast milk quinine concentrations and milk to plasma ratios were 0.5-3.6 mg 1-1 (mean 2.6) and 0.11-0.53 (mean 0.31) in twenty-five women who were breast-feeding and had taken oral quinine sulphate for 1-10 days (mean 4.0). Five women with more serious infections received intravenous quinine; breast milk quinine concentrations ranged between 0.5 and 8.0 mg 171 (mean 3.4). Corresponding milk to plasma ratios were 0.11 to 0.32 (mean 0.21).

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Drug-induced Blood Dyscrasias in Sweden

Cited by 149 publications

References 9 publications

Agranulocytosis in Bangkok, Thailand: a predominantly drug-induced disease with an unusually low incidence. Aplastic Anemia Study Group.

Agranulocytosis in Bangkok, Thailand: a predominantly drug-induced disease with an unusually low incidence. Aplastic Anemia Study Group.

Suppressive effect of antibiotics on colony formation from human megakaryocyte progenitors (CFU-M) and granulocyte-macrophage progenitors (CFU-GM).

Quinine pharmacokinetics and toxicity in pregnant and lactating women with falciparum malaria.

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