With increasing proliferation of drug combinations, it is ever more necessary for the physician to consider the possibile toxicity of each agent in a multiple remedy. When treatment is given for symptomatic purposes only, drugs used need special scrutiny, lest the patient be exposed to unnecessary risk. In the patient reported here, agranulocytosis followed prolonged use of a multiple antidiarrhea remedy which contained sulfaguanidine.
An 18-year-old girl, daughter of a physician, was admitted to the Swedish Hospital on July 25, 1937, for investigation of fever, anemia, and severe granulocytopenia. She had complained of easy fatigue of one month's duration, and two days before admission she noted a temperature which reached 104 F (40 C). She had no sore throat, but on two occasions within the two days, the leukocyte count was low and there was absence of granulocytes.Past history included a reaction at 4 years of age
Stevens AR. Agranulocytosis Induced by SulfaguanidineThe Danger of an Antibacterial Drug in a Symptomatic Remedy. Arch Intern Med. 1969;123(4):428–429. doi:10.1001/archinte.1969.00300140074016