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Descriptive Epidemiology of Agranulocytosis
Brian L. Strom, MD, MPH;
Jeffrey L. Carson, MD;
Rita Schinnar, MPA;
Ellen Sim Snyder, MS;
Michele Shaw, PharmD
Arch Intern Med. 1992;152(7):1475-1480.
Abstract
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Background.—
To determine the incidence of agranulocytosis, a descriptive epidemiologic study was performed.
Methods.—
With the use of computerized Medicaid billing data from 1980 through 1985 from Minnesota, Michigan, and Florida, the ratio of persons hospitalized with a discharge diagnosis of neutropenia to persons with any claim for medical service was first used as an estimate of the incidence rate of the condition. Patients with cancer and patients receiving cytotoxic and immunosuppressive drugs were excluded. The information provided by a review of medical records for a subset of neutropenia cases was used to determine the proportion with neutropenia after excluding cases with recurrent or chronic neutropenia, and to determine the proportion with agranulocytosis.
Results.—
The incidence rates (95% confidence intervals) of agranulocytosis, excluding recurrent or chronic disease, were 2.3 (1.4 to 3.7), 7.7(6.6 to 8.9), and 15.4 (11.3 to 20.4) per million per year in each state, respectively. The overall incidence was 7.2 (6.3 to 8.1) per million per year.
Conclusions.—
Agranulocytosis is an extremely uncommon condition. The excess risk of agranulocytosis due to any drug other than cytotoxic drugs must, therefore, be very low.
(Arch Intern Med. 1992;152:1475-1480)
Author Affiliations
From the Clinical Epidemiology Unit, General Internal Medicine Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia (Drs Strom and Carson and Mss Schinnar and Snyder); Division of General Internal Medicine, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ (Dr Carson); and Department of PostMarketing Surveillance, Health Information Designs Inc, Arlington, Va (Dr Shaw).
Footnotes
Accepted for publication December 16, 1991.
Presented in part at the Annual Meeting of the American Society for Clinical Pharmacology and Therapeutics, Nashville, Tennessee, March 9, 1989; and the IV World Congress of Clinical Pharmacology and Therapeutics, Mannheim, Germany, July 28, 1989.
Reprint requests to 221L NEB, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6095 (Dr Strom).
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