Dr Sachs and coworkers point to 2 important and related problems that occur in the evaluation of cases of drug-induced idiosyncratic neutropenia: (1) to identify the causative drug and (2) to improve understanding of mechanism(s) for the reaction. Identification might be easy when there is only 1 drug (eg, an antithyroid or clozapine) and disease. But the clinical reality is often more complex because a number of drugs may have been used simultaneously or sequentially (eg, in an intensive care unit, where a potentially life-threatening agranulocytosis complicates an already precarious situation). Identification is then urgent because this patient population usually needs multiple courses of related drugs (eg, high-dose antibiotic treatment).1
Palmblad J. Drug-Induced Allergic Cytopenia: In Vitro Confirmation by the Lymphocyte Transformation Test—Reply. Arch Intern Med. 2000;160(14):2219. doi:
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