TOXIC DEPRESSION OF THE MYELOID ELEMENTS FOLLOWING THERAPY WITH THE SULFONAMIDES; REPORT OF 8 CASES

Abstract
Three cases of leucopenia and 5 of agranulocytosis following sulfonamide therapy are reported. The incidence of sulfonamide toxicity on the myeloid elements was 0.65% in a series of 768 patients who received sulfonamide therapy at The Bronx Hospital from Jan. 1939 to Feb. 1941. Sulfapyridine proved slightly more toxic than sulfanilamide. Although a small dose may cause leucopenia or a fatal agranulocytosis (about 4 grams in 2 of the cases within 24 hrs.), these toxic effects on the bone marrow usually manifest themselves after prolonged use, especially in instances where the disease itself has a deleterious effect upon the hemopoietic system. Since the sulfonamides have a definite toxic effect on the bone marrow (as well as on other body organs), they should be used only when there is a definite indication. Promiscuous use for minor ailments, such as mild respiratory infections, tonsillitis, grippes, etc., is condemned. The authors also question the use of the sulfonamides prophylactically.

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