Metamizole sodium-induced severe aplastic anemia and its recovery with a short-course steroid therapy

Area of Science:

• Hematology
• Pharmacology
• Pediatrics

Background:

• Severe aplastic anemia developed in a young girl following a urinary tract infection.
• The patient was initially referred for bone marrow transplantation.
• A history of iatrogenic metamizole sodium overdose during the infection was uncovered.

Observation:

• The patient received a 3-day course of high-dose methylprednisolone followed by conventional steroid doses.
• Initial partial remission of hematologic parameters was observed within 30 days.
• Complete remission of all hematologic parameters was achieved within 4 months.

Findings:

• High-dose methylprednisolone therapy led to a complete remission in a case of severe aplastic anemia.
• The patient's aplastic anemia was potentially linked to metamizole sodium overdose.
• Steroid therapy demonstrated efficacy as an alternative treatment.

Implications:

• Careful questioning regarding drug history, particularly drug overdose, is essential in patients presenting with aplastic features.
• Steroid treatment can be a viable alternative for aplastic anemia, especially when iatrogenic drug use is identified.
• This case highlights the importance of considering drug-induced hematotoxicity in the differential diagnosis of aplastic anemia.