OBJECTIVE: In this article, we report and discuss the clinical presentation and management of idiosyncratic drug-induced agranulocytosis (neutrophil count <0.5 x 10(9)/l). RESULTS/CONCLUSIONS: Idiosyncratic drug-induced agranulocytosis remains a potentially serious adverse event owing to the frequency of severe sepsis with severe deep tissue infections (e.g., pneumonia), septicemia and septic shock in approximately two-thirds of all hospitalized patients. However, several prognostic factors have recently been identified that may be helpful in practice to identify 'susceptible' patients. Old age (>65 years), septicemia or shock, metabolic disorders such as renal failure and a neutrophil count below 0.1 x 10(9)/l are currently consensually accepted as poor prognostic factors. In this potentially life-threatening disorder, modern management with broad-spectrum antibiotics and hematopoietic growth factors (particularly granulocyte colony-stimulating factor) is likely to improve prognosis. Thus, with appropriate management, the mortality rate from idiosyncratic drug-induced agranulocytosis is currently approximately 5%.
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机译：目的：在本文中，我们报告并讨论特发性药物引起的粒细胞缺乏症（中性粒细胞计数<0.5 x 10（9）/ l）的临床表现和管理。结果/结论：由于约有三分之二的住院患者患有严重脓毒症并伴有严重的深部组织感染（如肺炎），败血病和败血性休克，特异药引起的粒细胞缺乏症仍是潜在的严重不良事件。但是，最近发现了一些预后因素，这些因素在实践中可能有助于识别“易感”患者。老年（> 65岁），败血病或休克，代谢性疾病（例如肾功能衰竭和中性粒细胞计数低于0.1 x 10（9）/ l）目前被认为是不良的预后因素。在这种潜在的威胁生命的疾病中，采用广谱抗生素和造血生长因子（尤其是粒细胞集落刺激因子）的现代治疗可能会改善预后。因此，通过适当的管理，特异药物诱导的粒细胞缺乏症的死亡率目前约为5％。
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