Clinical and Laboratory Features of Drug-Induced Agranulocytosis

 

Clinical findings:

(1) high fevers

(2) tachycardia

(3) prostration

(4) necrotic ulcerations involving the pharynx and the tonsils

(5) dysphagia

(6) skin eruption

(7) infrequently septic shock

 

Laboratory features:

(1) low absolute neutrophil count < 500 per µL (absolute neutropenia)

(2) other leukocytes present

(3) no or mild anemia (hematocrit >= 30%)

(4) no or mild thrombocytopenia (platelet count >= 100,000 per µL) unless DIC occurs

(5) absence of anti-neutrophil antibodies

 

Discontinuation of the causative drug should result in recovery of the neutrophil count in 2 to 4 weeks.

 

Exclusion:

(1) aplastic or hypoplastic anemia

(2) megaloblastic anemia

(3) leukemia or lymphoma

(4) autoimmune disease

(5) hypersplenism

(6) infectious or post-infectious neutropenia