Metamizole-induced agranulocytosis (MIA): a mini review.

IF 2.4 Q1 PEDIATRICS
Markos K Tomidis Chatzimanouil, Ines Goppelt, Yvonne Zeissig, Ulrich J Sachs, Martin W Laass
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引用次数: 1

Abstract

Metamizole is an analgesic, antipyretic, and spasmolytic drug in Germany only approved for the treatment of severe pain or high fever that does not respond to other measures. In recent years, an increased use has been described among both adults and children, often against the approved indication. The most important side effect of metamizole is the development of agranulocytosis (neutrophil count < 500/µL). Incidence of metamizole-induced agranulocytosis (MIA) ranges depending on the study from 0.96 cases per million per year to 1:1602 per patient and metamizole prescription. The risk of agranulocytosis in children remains unclear, but is probably lower than in adults. Female gender and older age are associated with higher incidence, reflecting prescription distribution. MIA is dose-independent and risk seems to increase with duration of intake. In patients with past exposure, re-exposure may lead to rapid onset. MIA is believed to be induced either through immunologic or toxic mechanisms. MIA presents with fever, sore throat, fatigue, and mucosal inflammation, up to ulceration. Even in the case of suspected MIA, treatment with metamizole should be immediately paused and an examination of the blood cell count is required. In case of local or systemic infections, empirical therapy with broad-spectrum antibiotics should be administered. G-CSF therapy should be limited to patients with poor prognostic factors. The patient should be monitored closely until the neutrophil count returns to normal. Re-exposure to metamizole must be avoided.

Abstract Image

Abstract Image

metamizole诱导的粒细胞缺乏症(MIA):一个小回顾。
在德国,Metamizole是一种镇痛、解热和解痉药,仅被批准用于治疗其他措施无效的严重疼痛或高热。近年来,在成人和儿童中有越来越多的使用,经常违反批准的适应症。甲硝唑最重要的副作用是粒细胞缺乏症(中性粒细胞计数)
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CiteScore
2.20
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