AGRANULOCYTOSIS ASSOCIATED WITH THENALIDINE (SANDOSTENE) TARTRATE THERAPY

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Abstract
Three cases of agranulocytosis are described. Two patients, aged 81 and 59 years, died. A third, aged 61, recovered despite a fall in white blood cell count to 950 per cubic millimeter, but was severely incapacitated by a cerebral vascular accident at the height of the illness. For reasons here given, it is believed that the drug responsible for the granulocytopenia was thenalidine. The maximum dosage taken by the first two patients was 75 mg. twice a day; the third patient took 75 mg. once a day for 40 days. In each case the thenalidine had been prescribed as an antihistaminic in the treatment of dermatitis or urticaria with pruritus, and after a period of considerable relief from this condition the patient developed fever with soreness of the mouth or throat. The physician who prescribes a potentially hematotoxic drug must be alert to the possibility of agranulocytosis in any patient who complains of sudden fever, chills, or sore throat.

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