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Agranulocytosis associated with sulfasalazine
1Department of Pharmacy Practice, University of Pittsburgh School of Pharmacy, PA.
Drug Intelligence & Clinical Pharmacy
|February 1, 1988
Summary
Sulfasalazine can cause agranulocytosis, a dangerous drop in white blood cells. Early recognition of symptoms like fever and sore throat is crucial for prompt treatment and recovery.
Area of Science:
- Pharmacology
- Hematology
- Clinical Medicine
Background:
- Sulfasalazine is a medication used to treat inflammatory conditions.
- Agranulocytosis is a rare but severe adverse effect associated with sulfasalazine therapy.
Observation:
- A 79-year-old woman developed agranulocytosis after seven weeks of sulfasalazine use.
- She presented with hoarseness, fever, odynophagia, and malaise.
- Initial lab results showed a white blood cell count of 600/mm3 with 0% neutrophils and bone marrow maturation arrest.
Findings:
- The patient's condition improved after discontinuing sulfasalazine.
- White blood cell counts and neutrophil levels normalized during hospitalization.
- Complete blood counts normalized by discharge, with WBC 12,000 cells/mm3 and 66% neutrophils.
Implications:
- Periodic complete blood counts are recommended for patients on sulfasalazine, particularly within the first two months.
- Patients should be educated to immediately report symptoms like fever, chills, or sore throat.
- Pharmacovigilance and patient counseling are vital for managing sulfasalazine-induced agranulocytosis.