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Bupropion-induced pancytopenia.

Jowon L Kim¹, David Chercover², Hamid Masoudi²

¹Division of Hematology, The University of British Columbia, Vancouver, British Columbia, Canada jowonlaura.kim@ubc.ca.

BMJ Case Reports

|November 27, 2024

Summary

This summary is machine-generated.

Bupropion may cause pancytopenia, a condition affecting all blood cell types. This case report details severe blood count reduction and rash after bupropion use, resolving upon drug cessation.

Keywords:

Drugs: psychiatry Haematology (drugs and medicines)Mood disorders (including depression)Safety Unwanted effects / adverse reactions

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Area of Science:

Hematology
Pharmacology
Toxicology

Background:

Bupropion is an antidepressant medication.
Medication-induced pancytopenia is a rare but serious adverse effect.
The association between bupropion and pancytopenia is not well-established.

Observation:

A patient developed agranulocytosis, normocytic anemia, and severe thrombocytopenia.
A drug-induced rash was concurrently observed.
These hematologic abnormalities occurred within three weeks of initiating bupropion therapy.

Findings:

Bone marrow biopsy revealed significant hypocellularity (<10%) without concerning features like dysplasia or increased blasts.
Extensive workup excluded other potential causes of cytopenias, including infections, nutritional deficiencies, autoimmune conditions, organ dysfunction, thrombotic microangiopathy, primary bone marrow disorders, and secondary marrow infiltration.
Pancytopenia resolved within one week of discontinuing bupropion and providing supportive care.

Implications:

This case suggests bupropion as a potential cause of drug-induced pancytopenia.
Clinicians should consider bupropion in the differential diagnosis of unexplained pancytopenia, especially with concurrent rash.
Further investigation may be warranted to confirm the causal link between bupropion and pancytopenia.