{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:18:21Z","timestamp":1790032701621,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,6,22]],"date-time":"2017-06-22T00:00:00Z","timestamp":1498089600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>\n                    Drug\u2010induced neutropenia and agranulocytosis are rare adverse events but can be fatal. Neutropenia can be induced by a myriad of drugs from almost every pharmacologic class. Octreotide is a somatostatin analog that has been used to treat variceal bleeding, acromegaly, and severe diarrhea associated with metastatic tumors, and to reduce symptoms in the setting of malignant bowel obstruction and pseudoobstruction. The most common adverse effects associated with octreotide include pain at the injection site and gastrointestinal effects such as loose stools, cramping, and nausea; neutropenia is not currently listed as an adverse effect of the drug. We describe the case of an 87\u2010year\u2010old man who developed neutropenia immediately after administration of three doses of subcutaneous octreotide. He presented to the hospital with a history of constipation and straining for 3\u00a0days. He was admitted, and laxatives, suppositories, and enemas were administered over the next 3\u00a0days to induce a bowel movement; however, they were ineffective. Bowel obstruction secondary to a mass was confirmed by computed tomography; the mass was eventually diagnosed as colon cancer. Octreotide 100\u00a0\u00b5g subcutaneously every 8\u00a0hours was started for the obstruction on the evening of hospital day 4. After the patient had received 3 doses of octreotide, his white blood cell count (\n                    <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content>\n                    ) had decreased from 4.1\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    (neutrophils 75.4%, absolute neutrophil count [\n                    <jats:styled-content style=\"fixed-case\">ANC<\/jats:styled-content>\n                    ] 3.1\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    ) on admission to 1.6\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    (neutrophils 62%,\n                    <jats:styled-content style=\"fixed-case\">ANC<\/jats:styled-content>\n                    0.99\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    ) on day 5. Given the temporal relationship of octreotide and neutropenia as well as the lack of a reasonable alternative cause, it was suspected that octreotide was the most likely culprit of the patient's neutropenia. Octreotide was subsequently discontinued, and his\n                    <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content>\n                    increased to 4.9\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    (neutrophils 66.3%,\n                    <jats:styled-content style=\"fixed-case\">ANC<\/jats:styled-content>\n                    3.2\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    ) the next day. The remainder of the patient's hospitalization was not significant for any further hematologic abnormalities. His\n                    <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content>\n                    and\n                    <jats:styled-content style=\"fixed-case\">ANC<\/jats:styled-content>\n                    (\n                    <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content>\n                    6.7\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    , neutrophils 83.2%,\n                    <jats:styled-content style=\"fixed-case\">ANC<\/jats:styled-content>\n                    5.6\u00a0\u00d7\u00a010\n                    <jats:sup>3<\/jats:sup>\n                    \/mm\n                    <jats:sup>3<\/jats:sup>\n                    ) remained stable 30\u00a0days after the incident. Use of the Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship (score of 5) between the patient's development of neutropenia and octreotide therapy. To our knowledge, this report highlights the first case of octreotide\u2010associated neutropenia. Although the frequency of drug\u2010induced neutropenia remains rare outside of cytotoxic chemotherapy, the importance of recognizing this adverse effect cannot be understated given the mortality risks for neutropenic patients.\n                  <\/jats:p>","DOI":"10.1002\/phar.1942","type":"journal-article","created":{"date-parts":[[2017,5,10]],"date-time":"2017-05-10T08:02:50Z","timestamp":1494403370000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Octreotide\u2010Associated Neutropenia"],"prefix":"10.1002","volume":"37","author":[{"given":"Stacy S.","family":"Tse","sequence":"first","affiliation":[{"name":"Geriatric Research Education and Clinical Centers James J. Peters VA Medical Center Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Kish","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Arnold and Marie Schwartz College of Pharmacy and Health Sciences Long Island University Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2004.09.008"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-004-0018-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.40.5712"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2014.09.013"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2011.12.006"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903328959"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation.V2012.1.485.3798522"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-103"},{"issue":"2","key":"e_1_2_6_10_1","first-page":"131","article-title":"Review: drug\u2010induced neutropenia\u2014pathophysiology, clinical features, and management","volume":"34","author":"Bhatt V","year":"2004","journal-title":"Ann Clin Lab Sci"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.8.869"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190014546115"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-9-200705010-00009"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2013.06.010"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.01454.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.156.11.4422"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V86.8.3181.3181"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"e_1_2_6_19_1","unstructured":"APP Pharmaceuticals LLC.Octreotide package insert.Schaumburg IL;2008."},{"key":"e_1_2_6_20_1","unstructured":"Novartis Pharmaceuticals Corporation 2014"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e328312180a"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9629(15)40844-4"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-5-286"},{"issue":"11","key":"e_1_2_6_24_1","first-page":"14","article-title":"Octreotide induced thrombocytopenia","volume":"3","author":"Yousaf H","year":"2012","journal-title":"Int J Case Rep Imag"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199001000-00035"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.7.4.481"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21433"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1430353"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1942","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1942","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T17:06:30Z","timestamp":1761066390000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1942"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1002\/phar.1942"],"URL":"https:\/\/doi.org\/10.1002\/phar.1942","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6]]},"assertion":[{"value":"2017-06-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}