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Reversible agranulocytosis associated with oral terbinafine in a pediatric patient
1Beaufort Naval Hospital Department of Pediatrics, Beaufort, Wisconsin, USA.
Insights
Terbinafine can cause agranulocytosis, a serious blood disorder, in children. This case highlights the need for blood monitoring and infection confirmation before prescribing terbinafine to pediatric patients.
Area of Science:
- Pediatric Hematology
- Dermatology
- Pharmacology
Background:
- Terbinafine is a widely used antifungal medication.
- Agranulocytosis is a rare but severe adverse effect associated with terbinafine.
- Data on severe side effects in pediatric patients are limited.
Observation:
- A pediatric patient developed agranulocytosis 4 weeks after initiating terbinafine therapy.
- The condition resolved spontaneously within one week without specific medical intervention.
- Symptoms were similar to those observed in adult patients.
Findings:
- Terbinafine-induced agranulocytosis can occur in children.
- The adverse effect resolved without granulocyte colony-stimulating factor (G-CSF) treatment.
- Recovery mirrored the course observed in adult cases.
Implications:
- This case underscores the importance of vigilant blood surveillance in children undergoing terbinafine treatment.
- Confirming the presence of infection prior to terbinafine initiation is crucial.
- Further research is needed to clarify the incidence of severe side effects in pediatric populations.
Abstract:
We report a case of terbinafine-induced agranulocytosis in a pediatric patient. This effect was noted 4 weeks after starting terbinafine and resolved within 1 week without the institution of therapy with granulocyte colony-stimulating factor, a course similar to reports in adults. With the incidence of severe side effects still unclear in children, this case argues for continued blood surveillance during courses of terbinafine and for the confirmation of infection before initiation of the drug.