Abstract
Agranulocytosis is defined as an absolute neutrophil count of less than 500/μL. Many drugs can cause agranulocytosis. We report a case of antibiotics-induced agranulocytosis in which information from our laboratory resulted in early treatment.The patient was a 67-year-old woman who had been diagnosed as having primary sclerosing cholangitis associated with bacterial infection. She was treated with several antibiotics. After two weeks, her leukocyte count decreased to 1.7×103/μL and the neutrophil percentage was 0%. We immediately reported to the doctors that the patient might have agranulocytosis. Early treatment was started and further evaluation was performed.Drug-induced agranulocytosis is considered to be caused by immunological or toxic mechanisms. Previous reports have shown that maturation arrest may be observed in patients with agranulocytosis mediated by toxic mechanisms. In this patient, bone marrow examination showed maturation arrest at the myelocyte stage, and this finding suggested that drug-induced agranulocytosis mediated by toxic mechanisms occurred.Because patients with agranulocytosis are likely to show complications caused by severe infections, an early detection of agranulocytosis is very important. Inadequate follow-up may occur in patients under treatment with drugs that rarely cause agranulocytosis. Quick reports to doctors may be required for a rapid diagnosis of antibiotics-induced agranulocytosis.
