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July 1939


Arch Intern Med (Chic). 1939;64(1):26-42. doi:10.1001/archinte.1939.00190010036003

The reproduction of the classic clinical picture of malignant neutropenia, or agranulocytic angina, in experimental animals has never been accomplished successfully. The situation in regard to aminopyrine as the most common etiologic agent in agranulocytic angina in man is much the same today as that in regard to cinchophen as the cause of acute necrosis of the liver. Cinchophen is generally accepted as the toxic agent in production of acute yellow atrophy in certain susceptible persons. In the experimental animal, however, cinchophen has never produced necrosis of the liver in any degree sufficient to simulate the condition in man. Aminopyrine today is accepted by many as the responsible agent in agranulocytic angina. True, it is apparently harmless to the vast majority of patients. Rawls1 estimated on clinical grounds that only 1 to 2 per cent of patients are susceptible to demonstrable changes in the peripheral blood; this view is

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