neutropenia vs. agranulocytosis

[MudPhud20XX]

So I was going over drugs that cause neutropenia/agranulocytosis and realized that I really don't know the diff btw these two. Aren't they pretty much the same yet the drugs are completely diff according to FA. Can anyone just explain the diff of these two?

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[seminoma]

Agranulocytosis = neutropenia, eosinopenia, basopenia, or any combination.
Neutropenia = neutropenia

 

[Phloston]

Yeah, agree with seminoma. Agranulocytosis is sometimes used interchangeably with neutropenia. If someone told me a patient was experiencing agranulocytosis, I'd assume mandatory neutropenia, then +/- eosinopenia/basopenia, even though it could technically be any or all of the three.

 

[cbrons]

So I was going over drugs that cause neutropenia/agranulocytosis and realized that I really don't know the diff btw these two. Aren't they pretty much the same yet the drugs are completely diff according to FA. Can anyone just explain the diff of these two?

Here is my amazing mnemonic that I made up for drugs that cause AGRANULOCYTOSIS (not exhaustive list but I think the really testable ones):

• Clozapine
  
• Propthiouracil
• Methimazole
• Carbamazepine
• Ticlopidine
• Dapsone
• Chloramphenicol

Causes Pretty Major Collapse To Defense Cells

 

[cbrons]

Agranulocytosis = neutropenia, eosinopenia, basopenia, or any combination.
Neutropenia = neutropenia

Not really, here is the UpToDate definition:

• Neutropenia is defined as an absolute neutrophil count (ANC) <1500/microL.

• Agranulocytosis literally means the absence of granulocytes (ie, ANC of zero), although the term is often used loosely to indicate severe degrees of neutropenia (ie, ANC <100, <200 or even <500/microL).

I like to think of agranulocytosis as very severe neutropenia, but of course it could mean your definition in some contexts but not exclusively.

 

[cbrons]

http://www.uptodate.com/contents/drug-induced-neutropenia-and-agranulocytosis

 

[MudPhud20XX]

Here is my amazing mnemonic that I made up for drugs that cause AGRANULOCYTOSIS (not exhaustive list but I think the really testable ones):

• Clozapine
  
• Propthiouracil
• Methimazole
• Carbamazepine
• Ticlopidine
• Dapsone
• Chloramphenicol

Causes Pretty Major Collapse To Defense Cells

Yup! Here are some more from FC.

The following are notable drugs that cause agranulocytosis:

• Carbamazepine
• Clozapine
• Colchicine
• Propylthiouracil
• Methimazole
• Dapsone
• Ticlopidine

Mnemonic: Can Certainly Cause Pretty Major Damage Too; Causes Pretty Major Collapse ToDefense Cells; Gangs CCCrush Myeloblasts and Promyelocytes

 

[seminoma]

For Step 1 you're probably not likely to be tested on dapsone for anything other than G6PD.

And for Step 2 as Rx for dermatitis herpetiformis

 

[MudPhud20XX]

Yup good point seminoma, just to reinforce what you mentioned, I found this from Goljan:

Most recent drug, Dapsone (used to Rx leprosy) is a sulfa and nitryl drug. Therefore does two things:
1) produce methemoglobin and 2) have potential in producing hemolytic anemia in glucose 6 phosphate dehydrogenase
deficiencies. Therefore, hemolysis in G6PD def is referring to oxidizing agents, causing an increase in peroxide, which
destroys the RBC; the same drugs that produce hemolysis in G6PD def are sulfa and nitryl drugs. These drugs also
produce methemoglobin. Therefore, exposure to dapsone, primaquine, and TMP-SMX, or nitryl drugs
(nitroglycerin/nitroprusside), there can be a combo of hemolytic anemia, G6PD def, and methemoglobinemia b/c they
are oxidizing agents. Common to see methemoglobinemia in HIV b/c pt is on TMP-SMX for Rx of PCP. Therefore,
potential complication of that therapy is methemoglobinemia.

 

[Phloston]

Here is my amazing mnemonic that I made up for drugs that cause AGRANULOCYTOSIS (not exhaustive list but I think the really testable ones):

• Clozapine
  
• Propthiouracil
• Methimazole
• Carbamazepine
• Ticlopidine
• Dapsone
• Chloramphenicol

Causes Pretty Major Collapse To Defense Cells

You should send as a suggestion to FA.

 

[Keto]

For Step 1 you're probably not likely to be tested on dapsone for anything other than G6PD.

And for Step 2 as Rx for dermatitis herpetiformis

... I think the whole medical community will never forget the association between dapsone and dermatitis herpetiformis, as UWorld QBank showed a very particular presentation of it ;-) (Step2; QId 2774)

 

[seminoma]

... I think the whole medical community will never forget the association between dapsone and dermatitis herpetiformis, as UWorld QBank showed a very particular presentation of it ;-) (Step2; QId 2774)

That UW question was the first and only time I've seen that association. In MS2 and throughout Step 1 UW the only association I saw was resolution with diet.

 

[MudPhud20XX]

... I think the whole medical community will never forget the association between dapsone and dermatitis herpetiformis, as UWorld QBank showed a very particular presentation of it ;-) (Step2; QId 2774)

Hey Keto, could you explain this further? I haven't seen this q in UW yet. I thought dermatitis herpetiformis was associated with Celiac dz and IgA path.

 

[Keto]

Hey Keto, could you explain this further? I haven't seen this q in UW yet. I thought dermatitis herpetiformis was associated with Celiac dz and IgA path.

This question was in the Step2 QBank and it showed a non-compliant celiac disease patient with dermatitis herpetiformis over his gluteal region. Treatment of choice was dapsone.

Our preferred approach to the treatment of DH consists of both pharmacotherapy and dietary therapy. For children and adults with DH, we suggest treatment with both dapsone and a gluten-free diet as initial therapy ( Grade 2A ). Subsequently, dapsone may be slowly tapered with the goal of sustaining remission with dietary therapy. (See 'Treatment' above.)