{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:51:24Z","timestamp":1791823884727,"version":"4.3.4"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Background\/Introduction: Few data is currently available on neutropenia and agranulocytosis related to drug intake.<\/jats:p>\n                  <jats:p>Aim: We report here data on 203 patients with established idiosyncratic drug-induced agranulocytosis, followed up in a referral centre within a university hospital.<\/jats:p>\n                  <jats:p>Design: Data from 203 patients with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed.<\/jats:p>\n                  <jats:p>Methods: All cases were extracted from a cohort study on agranulocytosis in the Strasbourg University Hospital (Strasbourg, France).<\/jats:p>\n                  <jats:p>Results: The mean age was 61.6 years old (range: 18-95), the gender ratio (F\/M) was 1.3. Several comorbidities were present in 63.5%. The most frequent causative drugs were: antibiotics (49.3%), especially \u03b2-lactams and cotrimoxazole; antithyroid drugs (16.7%); neuroleptic and anti-epileptic agents (11.8%); antiviral agents (7.9%); and platelet aggregation inhibitors as ticlopidine and acid acetylsalicylic (6.9%). The main primary clinical manifestations during hospitalization included: isolated fever (26.3%); septicaemia (13.9%); documented pneumonia (13.4%); sore throat and acute tonsillitis (9.3%); and septic shock (6.7%). The mean neutrophil count at nadir was 0.148 \u00d7 109\/L (range: 0-0.48). All febrile patients were treated with broad-spectrum antibiotics and 107 (52.7%) with hematopoietic growth factors. The mean duration of haematological recovery (neutrophil count \u22651.5 \u00d7 109\/L) was 7.8 (range: 2-20). This mean duration was reduced to 2.1 days (range: 2-16) (p=0.057) with hematopoietic growth factors. Outcome was favourable in 91.6% of patients; seventeen died. Thirty-seven patients (18.2%) required intensive care.<\/jats:p>\n                  <jats:p>Discussion\/Conclusion: The present study demonstrated that idiosyncratic drug-induced agranulocytosis is a relative rare events; that antibiotics, antithyroid, neuroleptic and anti-epileptic agents, and platelet aggregation inhibitors are the main incriminated drug classes; that agranulocytosis typically serious, with at least 50% exhibiting severe sepsis and a mortality rate &amp;lt;10%; and that modern management of such disorder may reduce the infection-related mortality.<\/jats:p>","DOI":"10.1093\/qjmed\/hcw220","type":"journal-article","created":{"date-parts":[[2017,1,9]],"date-time":"2017-01-09T20:50:20Z","timestamp":1483995020000},"page":"299-305","source":"Crossref","is-referenced-by-count":29,"title":["Idiosyncratic drug-induced neutropenia and agranulocytosis"],"prefix":"10.1093","volume":"110","author":[{"given":"E.","family":"Andr\u00e8s","sequence":"first","affiliation":[{"name":"From the 1Department of Internal Medicine of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mourot-Cottet","sequence":"additional","affiliation":[{"name":"From the 1Department of Internal Medicine of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Maloisel","sequence":"additional","affiliation":[{"name":"2Department of Onco-hematology of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"S\u00e9verac","sequence":"additional","affiliation":[{"name":"3Department of Statistics of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Keller","sequence":"additional","affiliation":[{"name":"From the 1Department of Internal Medicine of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Vogel","sequence":"additional","affiliation":[{"name":"4Department of Geriatrics of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Tebacher","sequence":"additional","affiliation":[{"name":"5The Regional Pharmacovigilance Centre of Alsace, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.-C.","family":"Weber","sequence":"additional","affiliation":[{"name":"From the 1Department of Internal Medicine of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Kaltenbach","sequence":"additional","affiliation":[{"name":"4Department of Geriatrics of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.-E.","family":"Gottenberg","sequence":"additional","affiliation":[{"name":"6Department of Rheumatology of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Goichot","sequence":"additional","affiliation":[{"name":"From the 1Department of Internal Medicine of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Sibilia","sequence":"additional","affiliation":[{"name":"6Department of Rheumatology of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.-S.","family":"Korganow","sequence":"additional","affiliation":[{"name":"From the 1Department of Internal Medicine of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Herbrecht","sequence":"additional","affiliation":[{"name":"2Department of Onco-hematology of the Strasbourg University Hospitals, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,2,4]]},"reference":[{"key":"2026071307102832900_hcw220-B1","first-page":"1495","article-title":"Uber eigenartige Halserkrankungen","volume":"48","author":"Schultz","year":"1922","journal-title":"Dtsc Med Wochenschr"},{"key":"2026071307102832900_hcw220-B2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1586\/ehm.11.12","article-title":"Clinical presentation and management of drug-induced agranulocytosis","volume":"4","author":"Andr\u00e8s","year":"2011","journal-title":"Expert Rev Hematol"},{"key":"2026071307102832900_hcw220-B3","doi-asserted-by":"crossref","first-page":"657\u201365.","DOI":"10.7326\/0003-4819-146-9-200705010-00009","article-title":"Non-chemotherapy drug-induced agranulocytosis: a systematic review of case reports","volume":"146","author":"Andersohn","year":"2007","journal-title":"Ann Intern Med"},{"key":"2026071307102832900_hcw220-B4","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/j.1365-2141.1991.tb08042.x","article-title":"Drug-induced agranulocytosis: prognostic factors in a series of 168 episodes","volume":"79","author":"Julia","year":"1991","journal-title":"Br J Hematol"},{"key":"2026071307102832900_hcw220-B5","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.3324\/haematol.2014.110288","article-title":"How we diagnose neutropenia in the adult and elderly patient","volume":"99","author":"Palmblad","year":"2014","journal-title":"Haematologica"},{"key":"2026071307102832900_hcw220-B6","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1093\/ageing\/28.3.325","article-title":"Drug-induced agranulocytosis in elderly. A case series of 25 patients","volume":"28","author":"Kurtz","year":"1999","journal-title":"Age Aging"},{"key":"2026071307102832900_hcw220-B7","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/S0953-6205(02)00085-7","article-title":"Modern management of non-chemotherapy drug-induced agranulocytosis: a monocentric cohort study of 90 cases and review of the literature","volume":"13","author":"Andr\u00e8s","year":"2002","journal-title":"Eur J Intern Med"},{"key":"2026071307102832900_hcw220-B8","first-page":"257","article-title":"Standardization of definitions and criteria for causality assessment of adverse drug reactions. Drug-induced blood cytopenias: report of an international consensus meeting","volume":"33","author":"B\u00e9nichou","year":"1993","journal-title":"Nouv Rev Fr Hematol"},{"key":"2026071307102832900_hcw220-B9","first-page":"171","article-title":"Imputabilit\u00e9 en pharmacovigilance: de la m\u00e9thode fran\u00e7aise originelle aux m\u00e9thodes r\u00e9actualis\u00e9es","volume":"71","author":"Miremont-Salam\u00e9","year":"2016","journal-title":"Th\u00e9rapie"},{"key":"2026071307102832900_hcw220-B10","first-page":"131","article-title":"Drug-induced neutropenia: pathophysiology, clinical features, and management","volume":"34","author":"Bhatt","year":"2004","journal-title":"Ann Clin Lab Sci"},{"key":"2026071307102832900_hcw220-B11","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1002\/pds.2630020706","article-title":"The drug etiology of agranulocytosis: an update of the International Agranu\u00a0locytosis and Aplastic Anemia Study","volume":"2","author":"Kaufman","year":"1993","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2026071307102832900_hcw220-B12","doi-asserted-by":"crossref","first-page":"573","DOI":"10.4269\/ajtmh.1999.60.573","article-title":"Agranulocytosis in Bangkok, Thailand: a predominantly drug-induced disease with an unusually low incidence. Aplastic Anemia Study Group","volume":"60","author":"Shapiro","year":"1999","journal-title":"Am J Trop Med Hyg"},{"key":"2026071307102832900_hcw220-B13","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1001\/archinte.159.4.369","article-title":"A population-based case-cohort study of drug-associated agranulocytosis","volume":"159","author":"van der Klauw","year":"1999","journal-title":"Arch Intern Med"},{"key":"2026071307102832900_hcw220-B14","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/(SICI)1096-8652(199803)57:3<206::AID-AJH4>3.0.CO;2-Z","article-title":"Drug-associated agranulocytosis: 20 years of reporting in the Netherlands (1974\u20131994)","volume":"57","author":"Van der Klauw","year":"1998","journal-title":"Am J Hematol"},{"key":"2026071307102832900_hcw220-B15","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1046\/j.1365-2125.2000.00132.x","article-title":"Epidemiology of drug exposure and adverse drug reactions in two Swiss departments of Internal Medicine","volume":"49","author":"Fattinger","year":"2000","journal-title":"Br J Clin Pharmacol"},{"key":"2026071307102832900_hcw220-B16","doi-asserted-by":"crossref","first-page":"427","DOI":"10.2165\/00002512-200421070-00002","article-title":"Life-threatening idiosyncratic drug-induced agranulocytosis in elderly patients","volume":"21","author":"Andr\u00e8s","year":"2004","journal-title":"Drugs Aging"},{"key":"2026071307102832900_hcw220-B17","first-page":"470","article-title":"Prognostic factors of hematological recovery in nonchemotherapy drug-induced agranulocytosis","volume":"88","author":"Maloisel","year":"2003","journal-title":"Haematologica"},{"key":"2026071307102832900_hcw220-B18","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/S0002-9343(02)01064-1","article-title":"Non-chemotherapy drug-induced agranulocytosis in elderly patients: the effects of Granulocyte Colony-Stimulating Factor","volume":"112","author":"Andr\u00e8s","year":"2002","journal-title":"Am J Med"},{"key":"2026071307102832900_hcw220-B19","first-page":"2031","article-title":"The application of hematopoietic growth factors in drug-induced agranulocytosis: a review of 70 cases","volume":"8","author":"Sprikkelman","year":"1994","journal-title":"Leukemia"},{"key":"2026071307102832900_hcw220-B20","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1592\/phco.19.4.299.30941","article-title":"Nonchemotherapy drug-induced agranulocytosis: a review of 118 patients treated with colony-stimulating factors","volume":"19","author":"Beauchesne","year":"1999","journal-title":"Pharmacotherapy"},{"key":"2026071307102832900_hcw220-B21","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1089\/thy.1999.9.29","article-title":"Granulocyte colony-stimulating factor (G-CSF) does not improve recovery from antithyroid drug-induced agranulocytosis: a prospective study","volume":"9","author":"Fukata","year":"1999","journal-title":"Thyro\u00efd"}],"container-title":["QJM: An International Journal of Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/qjmed\/article-pdf\/110\/5\/299\/16731759\/hcw220.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/qjmed\/article-pdf\/110\/5\/299\/16731759\/hcw220.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:10:37Z","timestamp":1783941037000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/qjmed\/article\/110\/5\/299\/2970052"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,4]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2017,2,4]]},"published-print":{"date-parts":[[2017,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/qjmed\/hcw220","relation":{},"ISSN":["1460-2725","1460-2393"],"issn-type":[{"value":"1460-2725","type":"print"},{"value":"1460-2393","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,5]]},"published":{"date-parts":[[2017,2,4]]}}}