AGRANULOCYTOSIS ASSOCIATED WITH ETODOLAC

OBJECTIVE: To report a case of probable etodolac-induced agranulocytos is. CASE SUMMARY: A 72-year-old woman who had been taking etodolac 300 mg bid for approximately six weeks presented to the emergency departm ent with symptoms of urosepsis. She was found to be profoundly granulo cytopenic. Etodolac was discontinued and broad-spectrum intravenous an tibiotic therapy was administered for the next 17 days. Results of bon e marrow biopsy revealed marked hypocellularity consistent with drug-i nduced agranulocytosis. Following etodolac withdrawal, the total white blood cell count reached a low value of 0.9 x 10(9)/L and then return ed to a pre-etodolac baseline after 15 days. Her hemoglobin concentrat ion also decreased significantly during hospitalization. DISCUSSION: A granulocytosis has rarely been reported in association with nonsteroi dal antiinflammatory drugs (NSAIDs). and there are no literature repor ts associating etodolac with agranulocytosis. This case involving etod olac is consistent with the pattern described with other NSAIDs. Facto rs correlating etodolac as the causative agent are identified. Details of patient history, treatment, follow-up, and assessment are discusse d. CONCLUSIONS: Detailed case assessment demonstrated probable etodola c-induced agranulocytosis in our patient. Clinicians should be aware t hat etodolac, like other NSAIDs, has potential to cause agranulocytosi s.