Sideroblastic Anemia in Chronic Phenacetin Misuse

Abstract

and InsUtute of Maternal and Child Health NoviSad, YugoslaviaThe pde d phenacetin-containiugaxtalgesics may result in various pathologlc effects in the circuiaUng blood and/or in the bone marrow. These pathologlc effects can be provoked by standard doses of phenacetin, by acute phenaceUn intoxication, and by the long-term use of the drug, Le., chmnic phenacetinism.This paper describea an effect of chromc phenacethism not yet fully recognized. In c a m patients consuming 1-7.5 gm phenaceth daily for 0.5-16 years, we found a dlsturtunce of iron uZilhaUon by the normoblasts d the bone marrow, referred to aa *Reprmt requests: Dr. Koata Popovi6, Interno odeljen~e U P k e b o h c e , 21000 Novi Sad., Hajduk Veljkovz 1, Yugoebviz 58 5 Copynp C 1 9 4 byM.rccl Dekkn.1~. AU R i @ m R a m e d Nether lhm *ot mun pa mrv b rrpodrndavvaruired inmy lama by am m a r r elarrmnr a m d u m a l . UulUdunJ phaocopmrg. nwc4ihrq. ud recadma. a ty any tnfa~cw aongcud CRml I V P~ wnboul p a m n c m ID ~f m m c h r p r M s b a Clinical Toxicology Downloaded from informahealthcare.com by Mcgill University on 12/09/14 For personal use only. Clinical Toxicology Downloaded from informahealthcare.com by Mcgill University on 12/09/14 For personal use only. Clinical Toxicology Downloaded from informahealthcare.com by Mcgill University on 12/09/14 For personal use only. Clinical Toxicology Downloaded from informahealthcare.com by Mcgill University on 12/09/14 For personal use only.

Drug-Induced Anemia and Other Red Cell Disorders: A Guide in the Age of Polypharmacy

“…Research suggests that linezolid-induced anemia is secondary to a chloramphenicollike suppression of erythropoiesis [19]. Progesterone replacement [20], tetracycline [21], phenacetin [22], and busulfan [23] have also been reported to cause sideroblastic anemia. Usually, sideroblastic anemia can be corrected by removing the offending agent.…”

“…Chelating agents [17] Penicillamine Triethylenetetramine dihydrochloride Antibiotics Chloramphenicol [18] Linezolid [19] Tetracycline [21] Others Busulfan [23] Isoniazid [16] Phenacetin [22] Progesterone replacement [20] Polycythemia Erythropoiesis Stimulating Agents [6] Anabolic Steroids [6] Methemoglobinemia Local anesthetics [34] Benzocaine Prilocaine Phenazopyridine Alkyl nitrites [34] Amyl nitrate Sulfonamides [32] Others [32] Azathioprine Chloramphenicol Isoniazid Procainamide…”

“…Usually, sideroblastic anemia can be corrected by removing the offending agent. Some of the drugs that commonly cause drug-induced sideroblastic anemia are listed in Table 2 [6,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34].…”