[Drug-induced (probably allopurinol) agranulocytosis. Case report and discussion]

Agranulocytosis is a rare but sometimes extremely dangerous adverse drug reaction which can be induced by almost any drug. We report the case of a 89-year-old man with a well-documented granulocyte chart, who received allopurinol in addition to preexisting therapy with cardiovascular drugs. Three weeks later agranulocytosis was found which bone-marrow biopsy indicated was drug-induced. After cessation of all drugs, isolation and antibiotic therapy, the leukocyte count returned to normal but the patient died four weeks later from progressive renal failure. A relation between allopurinol therapy and agranulocytosis was presumed. The drugs which might have caused this adverse reaction are discussed. The incidence, signs, symptoms and treatment are summarized and proposals are made concerning the action to be taken in the event of drug-induced agranulocytosis.