Les facteurs de croissance hématopoïétique ont-ils une place dans le traitement des agranulocytoses médicamenteuses?

Andrès, Emmanuel; Maloisel, Frédéric; Kurtz, Jean Emmanuel; Vinzio, S.; Sibilia, Jean; Schlieriger, J.L.; Dufour, Patrick

doi:10.1016/s0248-8663(00)80002-8

Cited by 12 publications

(10 citation statements)

References 13 publications

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“…When antibiotics are precociously administered, both the patient's complaints and the physical findings may be attenuated and fever may be the only symptom (Andrès et al. , 1998, 2000). In our experience of hospitalized DIA patients (which were obviously the most severe cases), clinical features included isolated fever in about 40%, septicaemia and septic shock in about 35% and documented infection in 25% (pneumonia in 10%, sore throat and acute tonsillitis in 7%, other deep infections in 8%) (partial data published in Andrès et al.…”

Section: Clinical Presentation and Differential Diagnosismentioning

confidence: 99%

“…, 1991), but it has recently dropped to less than 5%, probably due to improvements in the management and treatment of this condition (Sprikkelman, de Wolf & Vellenga, 1994; Beauchesne et al. , 1999; Andrès et al. , 2000, 2001).…”

Section: Clinical Presentation and Differential Diagnosismentioning

confidence: 99%

“…, 2001, in press). In our experience, G‐CSF and GM‐CSF were found to be useful in shortening the duration to blood count recovery without major toxicity or side‐effects (Andrès et al ., 2000, 2001, in press). We have previously shown that G‐CSF use was safe and led to a significant reduction in the mean duration to haematological recovery (5 vs .…”

Section: Managementmentioning

confidence: 99%

“…Most patients develop septicaemia and some have evidence of severe pneumonia as well as anorectal, skin or oropharyngeal infection and septic shock (Julia et al, 1991; Paitel et al, 1995;Vial et al, 1996;Andrès et al, 1998). When antibiotics are precociously administered, both the patient's complaints and the physical findings may be attenuated and fever may be the only symptom (Andrès et al, 1998(Andrès et al, , 2000. In our experience of hospitalized DIA patients (which were obviously the most severe cases), clinical features included isolated fever in about 40%, septicaemia and septic shock in about 35% and documented infection in 25% (pneumonia in 10%, sore throat and acute tonsillitis in 7%, other deep infections in 8%) (partial data published in Andrès et al, 1998Andrès et al, , 2000Andrès et al, , 2001.…”

Section: Clinical Findingsmentioning

confidence: 99%

“…When antibiotics are precociously administered, both the patient's complaints and the physical findings may be attenuated and fever may be the only symptom (Andrès et al, 1998(Andrès et al, , 2000. In our experience of hospitalized DIA patients (which were obviously the most severe cases), clinical features included isolated fever in about 40%, septicaemia and septic shock in about 35% and documented infection in 25% (pneumonia in 10%, sore throat and acute tonsillitis in 7%, other deep infections in 8%) (partial data published in Andrès et al, 1998Andrès et al, , 2000Andrès et al, , 2001. However, some patients remained asymptomatic (at least transiently), supporting the close monitoring of the blood count in individuals receiving high-risk medication such as antithyroid drugs or ticlopidine (Tajiri et al, 1990;Andrès et al, 2001).…”

Section: Clinical Findingsmentioning

confidence: 99%

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Nonchemotherapy drug-induced agranulocytosis: experience of the Strasbourg teaching hospital (1985-2000) and review of the literature

Andrès

Kurtz

Maloisel

2002

Clinical &Amp; Laboratory Haematology

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Agranulocytosis is a life-threatening disorder that frequently occurs as an adverse reaction to drugs. The overall incidence of nonchemotherapy drug-induced agranulocytosis (DIA) ranges from 2.6 to 10 cases per million patients exposed to drugs per year. Although patients experiencing DIA may initially be asymptomatic, the severity of the neutropenia usually leads to severe sepsis, requiring intravenous broad-spectrum antibiotic therapy. In this setting, old age, septicaemia, shock, and the metabolic complications of infection, such as renal failure, are poor prognostic variables. The severity of neutropenia (< 0.1 x 10(9))/l) and its duration (> 10 days) may also impact negatively on the outcome. With appropriate management using pre-established procedures, the mortality rate is now around 5%. Haematopoietic growth factors have been shown to shorten the duration of neutropenia in DIA. However, it has yet to be determined whether their use translates into a better outcome in DIA patients experiencing sepsis. DIA still remains a rare event. However, given the increased life expectancy and subsequent longer exposure to drugs, as well as the development of new agents, physicians should be aware of this complication and its management.

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Section: Clinical Presentation and Differential Diagnosismentioning

confidence: 99%