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Related Experiment Videos

Toenails and agranulocytosis.

P I Pillans1, I W Boyd

  • 1Department of Clinical Pharmacology, Princess Alexandra Hospital, Brisbane, Queensland, Australia. peter_pillans@health.qld.gov.au

Internal Medicine Journal
|July 21, 2007
PubMed
Summary
This summary is machine-generated.

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Terbinafine can cause severe neutropenia (low white blood cell count), a rare but serious side effect. Early recognition and drug withdrawal are crucial for patient recovery.

Area of Science:

  • Dermatology
  • Hematology
  • Pharmacology

Background:

  • Terbinafine is a widely used antifungal medication for skin and nail infections.
  • Granulocytopenia, including severe neutropenia and agranulocytosis, is a rare but potentially life-threatening adverse effect.
  • Understanding the clinical presentation and management of terbinafine-induced neutropenia is essential.

Observation:

  • A study reviewed 12 Australian cases of granulocytopenia linked to terbinafine use.
  • Patients were predominantly older women, with a mean age of 64 years.
  • Neutropenia typically developed within 4-5 weeks of terbinafine initiation and was often severe.

Findings:

  • Most cases presented with severe neutropenia (neutrophil counts < or = 0.3 x 10(3)/mm3).

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  • Symptoms included fatigue, fever, sore throat, and mouth ulceration.
  • One patient died from septic shock, while others required hospitalization, antibiotics, or granulocyte colony-stimulating factor.

    • Implications:

    • Terbinafine use can be associated with severe, rarely fatal, granulocytopenia.
    • Prompt discontinuation of terbinafine and management of neutropenia are critical.
    • Patients must be educated about the warning signs of this adverse reaction.