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Captopril-induced toxic epidermal necrolysis and agranulocytosis successfully treated with granulocyte
R I Winfred1, S Nanda, G Horvath
1Department of Medicine, West Virginia University School of Medicine, Morgantown 26505-9214, USA.
Abstract:
Captopril-induced bone marrow suppression is rare, except in certain high-risk patient populations. Severe exfoliative rashes have also been associated with captopril, but a combined presentation of toxic epidermal necrolysis and agranulocytosis has not been previously described. We report an unusual case of captopril-induced toxic epidermal necrolysis with agranulocytosis in a patient with no known risk factors. The bone marrow suppression was successfully treated using granulocyte colony-stimulating factor (G-CSF), and the white blood cell (WBC) count recovered within 3 days after starting therapy. This case underscores the early experience with captopril, which showed a strong correlation between high doses used to treat hypertension and bone marrow suppression.