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February 1958

Studies of the Bone Marrow in Immunological Granulocytopenia: Following Administration of Salicylazosulfapyridine

Author Affiliations

Seattle With the Technical Assistance of Mary Tibbetts, B.A., M.T.

From the Medical Service, Veterans' Administration Hospital, and the Department of Medicine, University of Washington School of Medicine.

AMA Arch Intern Med. 1958;101(2):244-251. doi:10.1001/archinte.1958.00260140076012

Severe granulocytopenia associated with a decreased resistance to infections was recognized as a new disease syndrome in 1922.1 Nine years later Kracke directed attention to the causal relationship of drugs.2,3 Shortly thereafter, Madison and Squier4 collected evidence that, of all drugs then in use, aminopyrine was most clearly implicated. These authors were also the first to reproduce granulocytopenia by the administration of aminopyrine to patients who had recovered from previous episodes associated with the use of an aminopyrine barbiturate preparation. A dose of 0.3 gm. by mouth was followed within hours by fever, malaise, and a precipitous fall in granulocytes in one patient. The second exhibited only a sharp drop in granulocyte count following the medication. These clinical experiments were repeated and confirmed by others.5,6

Plum's 7 studies of the bone marrow during the administration of aminopyrine to three sensitive patients are of particular interest. He noted a decrease in

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