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Hyperacute leucopenia associated with furosemide
Ben-Jiang Ma1,2
1IPC Healthcare/TeamHealth, Lake Mary, Florida, USA.
BMJ Case Reports
|November 24, 2017
Summary
Furosemide, a diuretic, can cause a rapid, temporary decrease in white blood cells (WBC). This transient hyperacute leukopenia resolved upon medication discontinuation, highlighting a potential adverse effect of furosemide.
Area of Science:
- Cardiology
- Pharmacology
- Hematology
Background:
- Congestive heart failure exacerbation necessitates diuretic therapy.
- Furosemide is a commonly prescribed loop diuretic for fluid overload.
Observation:
- A 72-year-old male experienced acute exacerbation of congestive heart failure.
- Intravenous furosemide administration led to a significant, transient drop in white blood cell (WBC) count.
- WBC count normalized after furosemide discontinuation and showed a mild decrease upon restarting oral furosemide.
Findings:
- The patient's WBC count decreased from 9.8 to 2.4×10^9/L within hours of intravenous furosemide.
- Discontinuation of furosemide resulted in WBC recovery to 7.1×10^9/L.
- A mild, transient leukopenia was observed upon reinitiation of oral furosemide.
Implications:
- Transient hyperacute leukopenia is a potential adverse effect of furosemide.
- Close monitoring of WBC count may be warranted during furosemide therapy, especially with intravenous administration.
- Understanding this adverse effect is crucial for managing patients on furosemide, particularly those with cardiovascular conditions.
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