Agranulocytosis in an arthritic patient treated with levamisole. A case report

A case of agranulocytosis in a man with nonspecific seronegative polyarthritis treated with levamisole in the form of a proprietary veterinary anthelmintic is described. At the time of presentation he had a relative monocytosis. Recovery was uneventful and was heralded and paralleled by an increase in monocytes, serum vitamin B12 and total vitamin B12 binding capacity. Levamisole induced agranulocytosis and the significance of monocytosis and serum vitamin B12 binding proteins in neutropenia are briefly reviewed.