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July 29, 1933


JAMA. 1933;101(5):368-369. doi:10.1001/jama.1933.02740300036013

Since the first detailed description1 of the disease now variously designated as agranulocytic angina, agranulocytosis, malignant neutropenia or granulopenia, more than five hundred acute or chronic cases have been reported. The typical acute attack is usually preceded by two or three days of prodromal symptoms, which generally consist of lassitude, malaise and sore throat. The anginal symptom is occasionally absent. These prodromal symptoms are followed by extreme weakness and almost complete prostration, death usually occurring in from two to three days. The mortality is about 85 per cent. If recovery takes place, a recurrence frequently follows in from one to three months.

The essential diagnostic feature of this disease is neutropenia, often amounting to almost complete absence of granulocytes. The total white cell count may or may not be lowered. The characteristic appearance at necropsy is a "liquefied" condition of the bone marrow. Ulcerative lesions of the mouth, anus

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