[17-year-old patient with neutropenia and fever during therapy with analgesics]. / 17-Jähriger patient mit neutropenie und fieber unter therapie mit analgetika.
Dtsch Med Wochenschr
; 136(8): 365-8, 2011 Feb.
Article
en De
| MEDLINE
| ID: mdl-21332035
ABSTRACT
HISTORY AND ADMISSION FINDINGS:
A 17-year-old patient was admitted to the hospital because of fever, shivering and odynophagia. After a pathologic fracture of the neck of the femur because of a preexisting bone cyst he had been taking a combined analgetic therapy with tilidin, metamizole and diclofenac for three weeks. Physical examination was completely normal. INVESTIGATIONS The differential blood count revealed a severe neutropenia of < 100/µl and an elevated C-reactive protein. Several blood cultures were negative. Despite multiple diagnostic procedures no focus of infection could be detected. A bone marrow biopsy showed an impaired maturation of granulocyte precursor cells with a predominance of promyelocytes. Acute leukaemia could be excluded. This finding is typical for a e. g. metamizole-induced agranulocytosis. TREATMENT AND COURSE Treatment consisted of reverse isolation, intravenous broad-spectrum antibiotics and granulocyte colony-stimulating factors. In the following days, the clinical condition of the patient improved considerably and the neutrophil blood count normalized.CONCLUSION:
This case report presents the clinical course of an acute drug-induced agranulocytosis. This condition has to be considered as a rare but potentially life-threatening side effect of a variety of drugs, for example metamizole, and requires immediate treatment.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dipirona
/
Agranulocitosis
/
Fiebre
/
Analgésicos
/
Neutropenia
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Adolescent
/
Humans
/
Male
Idioma:
De
Revista:
Dtsch Med Wochenschr
Año:
2011
Tipo del documento:
Article