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Editor's Correspondence
September 8, 2003

Trimethoprim-Sulfamethoxazole–Induced Life-Threatening Agranulocytosis

Arch Intern Med. 2003;163(16):1975-1976. doi:10.1001/archinte.163.16.1975

We read with great interest the review of Masters et al1 about trimethoprim-sulfamethoxazole (TMP-SMZ).1 It is a very high-quality article with critical review of the published data. However, we disagree with the commentaries of Masters et al concerning the hematological toxicity of TMP-SMZ, particularly concerning agranulocytosis.1 Thus, although TMP-SMZ–induced agranulocytosis is a "rare" adverse effect (the exact incidence is not known), it remains our opinion a serious potential life-threatening adverse effect,2 as we report herein.

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