RESUMO
A 56-year-old man developed procainamide-induced agranulocytosis. Bone marrow aspiration showed the absence of myeloid elements beyond the promyelocyte stage. Procainamide at therapeutic concentrations in vitro depressed bone marrow granulocyte-macrophage colonies (CFUc) while CFUc growth was normal in the absence of drug. Following the patient's recovery, CFUc growth was no longer suppressed by procainamide in vitro. The observations in this patient showing reversible sensitivity to drug contrast with those on other patients with drug-induced agranulocytosis that show persistent marrow injury or drug sensitivity despite clinical recovery.
Assuntos
Agranulocitose/patologia , Medula Óssea/patologia , Procainamida/efeitos adversos , Agranulocitose/induzido quimicamente , Ensaio de Unidades Formadoras de Colônias , Fatores Estimuladores de Colônias/farmacologia , Granulócitos/patologia , Células-Tronco Hematopoéticas/patologia , Humanos , Macrófagos/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
Two patients developed paraplegia associated with the use of the intraaortic balloon pump. In one patient, transient spinal ischemic episodes ceased after removal of the intraaortic balloon and the second patient apparently sustained spinal cord infarction. Possible etiologic mechanisms include vascular occlusion due to balloon position, arterial spasm, thromboembolic phenomena, hypotension, hypoxia and arterial dissection.