[Recurrent agranulocytosis after taking calcium dobesilate]

A 64-year-old woman fell ill with generalized pyoderma and fever up to 40 degrees C. White cell count was 600/microliters, with 96% lymphocytes. Granulopoiesis in the bone marrow was markedly diminished. After treatment with cefotaxime, 2 g twice daily for one week, the blood count returned to normal. 8 months later generalized pyoderma, fever and agranulocytosis (white cell count 700/microliters) recurred. Once again the findings improved on ofloxacin 200 mg twice daily for 9 days. On repeat questioning about previous drug intake the patient stated that each time before the onset of the agranulocytosis she had taken calcium dobesilate, 500 mg twice daily for the preceding 15 and 3 weeks, respectively. Thereupon a lymphocyte transformation test was performed which revealed significant stimulation by calcium dobesilate 4, 8 and 14 weeks after the second episode of agranulocytosis. -Allergic side effects of calcium dobesilate have repeatedly been reported, but there has been no previously published report of agranulocytosis induced by this drug.