| Abstract | PURPOSE: LATIN is a multinational case-control study designed to identify risk factors for agranulocytosis and to estimate the incidence rate of the disease in some Latin American countries. METHODS: Each study site in Brazil, Argentina and Mexico conducted an active search of agranulocytosis patients in hematology clinics and looked for possible associations with drug use. RESULTS: The overall incidence rate was 0.38 cases per 1 million inhabitant-years. Agranulocytosis patients more often took medications already associated with agranulocytosis than controls (p = 0.01), mainly methimazole (OR 44.2, 95% CI 6.8 to infinity). The population attributable risk percentage (etiologic fraction) was 56%. The use of nutrient supplements was more frequent among patients than controls (p = 0.03). CONCLUSIONS: Agranulocytosis seems to be very rare in Latin America. The lower than expected number of cases identified during the study period precluded estimation of the risk associated to individual drugs, with the exception of methimazol. However, this is the longest series of agranulocytosis cases ever gathered in Latin America, and information on drug exposures was collected prospectively. The conclusion is that drug-induced agranulocytosis does not seem to be a major public health problem in the study regions. |
| Authors | Nelson Hamerschlak, Eliane Maluf, Alexandre Biasi Cavalcanti, Alvaro Avezum Júnior, José Eluf-Neto, Roberto Passeto Falcão, Irene Gyongyvér Heidemarie Lorand-Metze, Daniel Goldenberg, Cézar Leite Santana, Daniela de Oliveira Werneck Rodrigues, Leny Nascimento da Motta Passos, Erika Oliveira de Miranda Coelho, Maria Carolina Tostes Pintão, Hélio Moraes de Souza, José Rafael Borbolla, Ricardo Pasquini
(Affiliation: Centro de Pesquisa Clínica, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Piso Chinuch, São Paulo, Brazil. hamer at einstein.br)
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| Journal | European journal of clinical pharmacology
(Eur J Clin Pharmacol)
Vol. 64
Issue 9
Pg. 921-9
(Sep 2008)
ISSN: 1432-1041 Germany |
| PMID | 18581105
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Antithyroid Agents
- Methimazole
|
| Topics |
- Aged
- Agranulocytosis
(chemically induced, epidemiology)
- Antithyroid Agents
(adverse effects)
- Case-Control Studies
- Child
- Data Collection
- Female
- Humans
- Incidence
- Interviews as Topic
- Latin America
(epidemiology)
- Male
- Methimazole
(adverse effects)
- Middle Aged
- Occupational Exposure
- Questionnaires
- Risk Factors
|
