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Related Experiment Videos

Captopril-induced agranulocytosis: a case report

T H Young1, S H Lin, W S Ko

  • 1Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|February 1, 1993
PubMed
Summary

Captopril can cause severe neutropenia, a dangerous drop in white blood cells, particularly in patients with kidney issues. Monitoring blood counts is crucial during the initial months of treatment.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Hematology

Background:

  • Hypertension and chronic renal failure are common comorbidities.
  • Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to manage hypertension.
  • Patients with impaired renal function may have altered drug metabolism and excretion.

Observation:

  • A patient with chronic renal failure and hypertension developed severe neutropenia (600/cu mm) three weeks after starting captopril 12.5 mg twice daily.
  • Symptoms included chills, high fever, and sore throat.
  • Bone marrow examination revealed a paucity of the myeloid series.

Findings:

  • Neutrophil counts normalized two weeks after discontinuing captopril.
  • Antineutrophil antibodies were not detected, suggesting a non-immune mechanism or a different antibody target.

Related Experiment Videos

  • The case highlights a potential adverse effect of captopril on neutrophil production.

    • Implications:

    • Careful monitoring of peripheral white blood cell counts is recommended for patients on captopril, especially those with impaired renal function.
    • Early detection and discontinuation of captopril may prevent severe neutropenia.
    • This case underscores the importance of vigilant pharmacovigilance for ACE inhibitors.