{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:34:51Z","timestamp":1791977691685,"version":"4.4.0"},"reference-count":91,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T00:00:00Z","timestamp":1591747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Agranulocytosis is a rare, but serious and life-threatening hematologic disorder in elderly patients. Idiosyncratic drug-induced agranulocytosis (IDIA) has been classically defined by a neutrophil count below 0.5 \u00d7 109\/L. The annual incidence of IDIA in Europe is about 1.6\u20139.2 cases per million inhabitants. Increasing age and female sex have been considered as risk factors for the development of this condition. Besides, it is well known that older people take on average more drugs than younger people. This condition is most often associated with the intake of antibacterial agents, antiplatelets, antithyroids, antipsychotics, antiepileptics and nonsteroidal anti-inflammatory drugs (NSAIDs). Initially, agranulocytosis may present without symptoms, but may quickly progress to a severe infection and sepsis. The causative drug should be immediately stopped. In febrile patients, blood cultures and where indicated, site-specific cultures should be obtained and early treatment with empirical broad-spectrum antibiotics started. Even with adequate treatment, the mortality rate is higher in elderly patients reaching up to 20%. Hematopoietic growth factors have proven to be useful as they shorten the duration of neutropenia. However, data on neutropenia and agranulocytosis in the elderly meeting the criteria of evidence-based medicine are still poor in the literature. This review analyzes the results of our experience as well as other published studies of the universal literature.<\/jats:p>","DOI":"10.3390\/jcm9061808","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:50:49Z","timestamp":1592268649000},"page":"1808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Idiosyncratic Drug-Induced Neutropenia and Agranulocytosis in Elderly Patients"],"prefix":"10.3390","volume":"9","author":[{"given":"Noel","family":"Lorenzo-Villalba","sequence":"first","affiliation":[{"name":"Diab\u00e8tes et Maladies M\u00e9taboliques, Service de M\u00e9decine Interne, H\u00f4pitaux Universitaires de Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Belen","family":"Alonso-Ortiz","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Interna, Hospital Universitario de Gran Canaria Dr Negrin, 35000 Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmine","family":"Maouche","sequence":"additional","affiliation":[{"name":"Diab\u00e8tes et Maladies M\u00e9taboliques, Service de M\u00e9decine Interne, H\u00f4pitaux Universitaires de Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abrar-Ahmad","family":"Zulfiqar","sequence":"additional","affiliation":[{"name":"Diab\u00e8tes et Maladies M\u00e9taboliques, Service de M\u00e9decine Interne, H\u00f4pitaux Universitaires de Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7914-7616","authenticated-orcid":false,"given":"Emmanuel","family":"Andr\u00e8s","sequence":"additional","affiliation":[{"name":"Diab\u00e8tes et Maladies M\u00e9taboliques, Service de M\u00e9decine Interne, H\u00f4pitaux Universitaires de Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,10]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2020, May 11). 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