Nitrofurantoin-induced agranulocytosis.
Vanessa Lopes1, Joana Ramos2, Patrícia Dias2
1Cardiology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal vlopes.pt@gmail.com.
Nitrofurantoin can cause agranulocytosis, a dangerous drop in white blood cells. Promptly stopping this drug led to full recovery, highlighting the need for careful patient monitoring during treatment.
Area of Science:
- Pharmacology
- Hematology
- Clinical Medicine
Background:
- Idiosyncratic drug-induced agranulocytosis is a rare, severe adverse reaction.
- Nitrofurantoin is commonly prescribed for urinary tract infections.
- While linked to hematological issues, nitrofurantoin-induced agranulocytosis is seldom reported.
Observation:
- A 68-year-old woman developed fever and agranulocytosis after nitrofurantoin treatment.
- Diagnostic workup, including bone marrow aspiration, yielded unremarkable results.
- Neutrophil counts normalized after discontinuing nitrofurantoin.
Findings:
- This case demonstrates a rare instance of nitrofurantoin-induced agranulocytosis.
- The patient experienced a complete hematological recovery upon drug withdrawal.
- Excluding other causes was crucial for attributing agranulocytosis to nitrofurantoin.
Implications:
- Clinicians must consider nitrofurantoin as a potential cause of agranulocytosis.
- Vigilant monitoring for hematological adverse events is essential during nitrofurantoin therapy.
- Even widely used medications can pose risks for severe, idiosyncratic reactions.
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