Drug-induced agranulocytosis: review of possible mechanisms, and prospects for clozapine studies

✍ Scribed by Frans H. J. Claas

• Publisher: Springer
• Year: 1989
• Tongue: English
• Weight: 622 KB
• Volume: 99
• Category: Article
• ISSN: 0033-3158
• DOI: 10.1007/bf00442574

✦ Synopsis

Although toxicity and inborn errors of metabolism may also be involved, immunological reactions play an important role in the induction of drug-induced agranulocytosis. Drug-induced antibodies may lead to agranulocytosis by at least three different immunological mechanisms. Immune complexes may selectively adhere to granulocytes or t~eir immature precursor cells, the drug may bind to the granulocytes as carriers of the immunogenic drug and finally the drug may induce antibodies directed to granulocyte-specific structures. The use and the interpretation of in vitro assays to detect drug-dependent antibodies against granulocytes or myeloid precursor cells are discussed. These assays will be used to detect a possible immunological mechanism involved in clozapine-induced agranulocytosis. Further studies will concern the identification of possible genetic risk factors associated with clozapine-induced agranulocytosis.