Abstract

Case Report

Fatal agranulocytosis associated with Metamizole treatment in a 16-year-old girl

Packo Dieu-le-veut Saint-Cyr Sylvestre*, Nanho Danho Clotaire, N’dhatz Comoe Emeraude, Boidy Kouakou, Camengo Police Serge Magloire, Diakité Mamady, Mbelesso Pascal and Koffi Kouassi Gustave

Published: 02 October, 2019 | Volume 3 - Issue 1 | Pages: 035-037

Agranulocytosis is one of the common reasons of consultation in hematology. It’s life-threatening because of an infection risk. The metamizole is a drug, known for its potential rare danger of inducing a severe agranulocytosis. However, it remains widely used because of its beneficial effect analgesic and antipyretic. We report in this study, a case of a girl who was 16 years old, referred for severe agranulocytosis, and appeared two weeks after treatment with Novalgin. The clinico-biological symptoms were dominated by Streptococcal septicemia with an infectious pulmonary and digestive focus. The blood cell count confirmed a severe agranulocytosis with total disappearance of neutrophils. Despite broad-spectrum antibiotic therapy and stimulation with hematopoietic growth factor, the clinical evolution was fatal in the short term. What motivates us to add this case to those of the literature in order to remind practitioners about the danger of this drug, and to promote has doubled of vigilance during use.

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Keywords:

Agranulocytosis; Novalgin

References

  1. Fillet, Georges. Agranulocytose médicamenteuse. Méd et hyg. 1984; 42: 2533-2541.
  2. Bassetti S. Absence of evidence is not evidence of absence. In Forum Médical Suisse 2017; 17: 1059-1060.
  3. Garcia S, Canionero M, Lopes G. Dipyrone-induced granulocytopenia: a case for awareness. Pharmacotherapy. 2006; 26:440-442. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16503727
  4. Haschke M, Liechti ME. Métamizole: bénéfices et risques par rapport au paracétamol et aux AINS. Forum Med Suisse. 2017; 17:1067–1073.
  5. Gupta BMD. Rapport sur un cas mortel d'agranulocytose. Ind Med Gaz. 1936; 71: 589-590. PubMed PMID: 29013107; PubMed Central PMCID: PMC5170691.
  6. Rollason V, Desmeules JA. Use of metamizole in children and the risk of agranulocytosis. Is the benefit worth the risk?. Eur J Anaesthesiol. 2015; 32:837-848. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26509242
  7. Benjamin J, Biederman J. Agranulocytic leukopenia induced by a drug related to aminopyrine. Journ Am Med. 1936; 107:493-494.
  8. Fieler M, Eich C, Becke K, Badelt G, Leimkühler K, et al. Metamizole for postoperative pain therapy in 1177 children. A prospective, multicentre, observational, post authorisation safety study. Eur J Anaesthesiol 2015; 32:839-843. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26086280
  9. Altman D, Bland J. Absence of evidence is not evidence of absence. Br Med Journ 1995; 311: 485.
  10. Huber M, Andersohn F, Sarganas G, Bronder E, Klimpel A, et al. Metamizole-induced agranulocytosis revisited: results from the prospective Berlin Case–Control Surveillance Study. Eur J Clin Pharmacol 2015; 71:219-227. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25378038
  11. Salama A, Schtz B, Kiefel V, Breithaupt H, Mueller‐Eckhardt C. Immune-mediated agranulocytosis related to drugs and their metabolites: mode of sensitization and heterogeneity of antibodies. Br J Haematol 1989; 72:127-132. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2788011
  12. Paitel JF, Stockemer V, Dorvaux V, Witz F, Guerci A, et al. Agranulocytoses aiguës médicamenteuses. Etude clinique à propos de 30 patients et évolution des étiologies sur 2 décennies. Rev méd int. 1995; 16:495-499.

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  • Fatal agranulocytosis associated with Metamizole treatment in a 16-year-old girl
    Packo Dieu-le-veut Saint-Cyr Sylvestre*, Nanho Danho Clotaire, N’dhatz Comoe Emeraude, Boidy Kouakou, Camengo Police Serge Magloire, Diakité Mamady, Mbelesso Pascal and Koffi Kouassi Gustave Packo Dieu-le-veut Saint-Cyr Sylvestre*,Nanho Danho Clotaire,N’dhatz Comoe Emeraude,Boidy Kouakou,Camengo Police Serge Magloire,Diakité Mamady,Mbelesso Pascal,Koffi Kouassi Gustave. Fatal agranulocytosis associated with Metamizole treatment in a 16-year-old girl. . 2019 doi: 10.29328/journal.acr.1001019; 3: 035-037

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