Agranulozytose nach Metamizol-Einnahme – ein unterschätztes Risiko?

Schinz K, Wüst W, Iro H, Waldfahrer F (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Laryngo-Rhino-Otologie Georg Thieme Verlag

Abstract

OBJECTIVE: Metamizole was the second most common drug prescribed in Germany in 2018 despite the known risk of agranulocytosis and the strict indication. According to Stammschulte et al. up to 25 % of all prescriptions are off-label use. Although mandatory according to the prescribing information of metamizole, regular blood cell counts are not performed in up to 50 % of the patients with long-term use of this drug. MATERIAL AND METHODS: Retrospective analysis of eight cases metamizole-induced agranulocytosis over a period of five years (2016-2020) in the university ENT department in Erlangen. Five patients were men and three women. Mean age of diagnosis was 52,4 years (± 25,6). RESULTS: Agranulocytosis after use of metamizole is a serious adverse drug reaction that may affect patients of all ages. Frequently, only distinct clinical symptoms such as temperature of unknown origin, dysphagia and tonsillitis in combination with abscesses in the head and neck area result in the detection of a metamizole-induced agranulocytosis. An agranulocytosis provokes partially radical surgery and/ or intensive-care measures and could lead to sepsis with organ failure or even to death. CONCLUSIONS: These patient cases show that agranulocytosis is a dangerous or even deadly adverse drug reaction after use of metamizole. Although the risk of agranulocytosis appears to increase with duration of use, we would recommend patient education as well as documentation of even a single administration of metamizole. This may facilitate early diagnosis of metamizole-induced agranulocytosis and thus prevent the onset of severe complications with possible lethal outcome.

Authors with CRIS profile

Katharina Schinz Department of Otorhinolaryngology – Head and Neck Surgery Wolfgang Wüst Medizinische Fakultät Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Frank Waldfahrer Department of Otorhinolaryngology – Head and Neck Surgery

How to cite

APA:

Schinz, K., Wüst, W., Iro, H., & Waldfahrer, F. (2020). Agranulozytose nach Metamizol-Einnahme – ein unterschätztes Risiko? Laryngo-Rhino-Otologie. https://doi.org/10.1055/a-1190-4445

MLA:

Schinz, Katharina, et al. "Agranulozytose nach Metamizol-Einnahme – ein unterschätztes Risiko?" Laryngo-Rhino-Otologie (2020).

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