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In a recent article by van der Klauw et al,¹ it was observed that the highest risks for developing drug-induced agranulocytosis were found for thyroid inhibitors, sulfamethoxazole-trimethoprim, sulfasalazine, chlomipramine hydrochloride, and dipyrone combined with analgesics. In a less sophisticated survey of all cases of drug-induced neutropenia that were reported into the computerized patient diagnosis register in Stockholm, Sweden, more than 20 years ago, my colleague and I² found strikingly similar results. Although the panorama of drugs that are available in the marketplace has changed so much over the years, those causing neutropenia are still very similar and still on the market. It is of interest to note that although agranulocytosis (and other blood dyscrasias) caused by sulfamethoxazole-trimethoprim is seldom fatal, it is extremely costly for society.³

Jan Palmblad, MD, PhD
Huddinge, Sweden

1. van der Klauw MM, Goudsmit R, Halie MR, et al. A population-based case-cohort study of drug-associated agranulocytosis. Arch Intern Med. 1999;159:369-374. FREE FULL TEXT 2. Arneborn P, Palmblad J. Drug-induced neutropenia: survey for Stockholm 1973-1978. Acta Med Scand. 1982;212:289-292. PUBMED 3. Keisu M, Wiholm BE, Palmblad J. Trimethoprim-sulfamethoxazole–associated blood dyscrasias. J Intern Med. 1990;228:353-360. WEB OF SCIENCE | PUBMED

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We would like to thank Dr Palmblad for his interest in our article.¹ Indeed, In their . . . [Full Text of this Article]

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