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Erythropoietic Changes During Therapy with Chloramphenicol

Erythropoietic Changes During Therapy with Chloramphenicol Abstract Anemic crises occur during the course of chronic hemolytic anemias, both congenital1-3 and acquired.4-6 These crises, due to temporary cessation of red cell production, are usually related to acute viral infections. Acute erythroblastopenia has also been reported in relation to treatment with various drugs, including chloramphenicol.7-10 The cases reported here are noteworthy for 4 reasons. First, they represent examples of anemic crisis occurring in the course of serious constitutional illnesses in which hemolysis did not seem to be important prior to the appearance of the crisis. Second, all 4 patients studied were receiving chloramphenicol at the time of development of erythroblastopenia. Third, striking "toxic" changes were noted in bone marrow cells at the height of the crisis in all 4 cases; changes of the type to be described have not been emphasized in most previous reports. Finally, in 1 of the 4 cases evidence has been obtained References 1. We are indebted to Dr. Herman W. Baker of The Mount Sinai Hospital, New York, for these determinations. 2. We are indebted to Dr. A. Leonard Luhby of the New York Medical College for these determinations. 3. The test is run over a 5-day period with the administration of 15 gm. of L-histidine monohydrochloride on the second, third and fourth days. 4. Owren, P. A.: Congenital Hemolytic Jaundice: The Pathogenesis of the "Hemolytic Crisis," Blood 3:721, 1948. 5. Singer, K.; Motulsky, A. G., and Wile, S. A.: Aplastic Crisis in Sickle Cell Anemia , J. Lab. Clin. Med. 35:721, 1950. 6. Dameshek, W., and Bloom, M. L.: The Events in the Hemolytic Crisis of Hereditary Spherocytosis with Particular Reference to Reticulocytopenia, Pancytopenia, and Abnormal Splenic Mechanism , Blood 3:1381, 1948. 7. Miesch, D. C.; Baxter, M. R., and Levin, W. C.: Acute Erythroblastopenia , A.M.A. Arch. Intern. Med. 99:461, 1957.Crossref 8. Chernoff, A. I., and Josephson, A. M.: Acute Erythroblastopenia in Sickle-Cell Anemia and Infectious Mononucleosis , A.M.A. Amer. J. Dis. Child. 82:310, 1951. 9. Crosby, W. H.: Paroxysmal Nocturnal Hemoglobinuria: A Report of a Case Complicated by an Aregenerative (Aplastic) Crisis , Ann. Intern. Med. 39:1107, 1953.Crossref 10. Osgood, E. E.: Hypoplastic Anemias and Related Syndromes Caused by Drug Idiosyncrasy , J.A.M.A. 152:816, 1953.Crossref 11. Volini, I. F.; Greenspan, I.; Ehrlich, L.; Gonner, J. A.; Felsenfeld, O., and Schwartz, S. O.: Hemopoietic Changes During the Administration of Chloramphenicol , J.A.M.A. 142:1333-1335, 1950.Crossref 12. Lindau, W.: Effect of Chloramphenicol upon Erythropoieses , in Proceedings of the American Federation for Clinical Research, Annual Meeting, Atlantic City, May, 1952 . 13. Krakoff, I. H.; Karnofsky, D. A., and Burchenal, J. H.: Effects of Large Doses of Chloramphenicol on Human Subjects , New Engl. J. Med. 253:7, 1955.Crossref 14. Erslev, A.: Hematopoietic Depression Induced by Chloromycetin , Blood 8:170, 1953. 15. Hodgkinson, R.: Blood Dyscrasias Associated with Chloramphenicol , Lancet 1:285, 1954.Crossref 16. Smiley, R. K.; Cartwright, G. E., and Wintrobe, M. M.: Fatal Aplastic Anemia Following Chloramphenicol Administration , J.A.M.A. 149: 914, 1952.Crossref 17. Rich, M. L.; Ritterhoff, R. J., and Hoffman, R. J.: A Fatal Case of Aplastic Anemia Following Chloramphenicol Therapy , Ann. Intern. Med. 33:1459, 1950.Crossref 18. Claudon, P. B., and Holbrook, A. A.: Fatal Aplastic Anemia Associated with Chloramphenicol Therapy , J.A.M.A. 149:912, 1952.Crossref 19. Sturgeon, P.: Fatal Aplastic Anemia in Children Following Chloramphenicol Therapy , J.A.M.A. 149:918, 1952.Crossref 20. Smith, R. M.; Joslyn, D. A.; Gruzhit, O. M.; McClean, W. I., Jr.; Penner, M. A., and Erlich, J.: Chloromycetin: Biological Studies , J. Bact. 55:425, 1948. 21. Cone, T. E., Jr., and Abelson, S. M.: Aplastic Anemia Following 2 Days of Chloramphenicol Therapy , J. Pediat. 41:340, 1952.Crossref 22. Ozer, F. L.; Truax, W. E., and Levin, W. C.: Erythroid Hypoplasia Associated with Chloramphenicol Therapy , Blood 16:997, 1960. 23. Smadel, J. E.: Chloramphenicol in the Therapy of Infectious Diseases , Amer. J. Med. 7:671, 1949.Crossref 24. Hargraves, M. M.; Mills, S. D., and Heck, F. J.: Aplastic Anemia Associated with the Administration of Chloramphenicol , J.A.M.A. 149: 1293, 1952.Crossref 25. Rubin, D.; Weisberger, A. S.; Botti, R. E., and Storaaski, J. P.: Changes in Iron Metabolism in Early Chloramphenicol Toxicity , J. Clin. Invest. 37:1286, 1958.Crossref 26. Saidi, P., and Wallerstein, R. O.: Effect of Chloramphenicol on Erythropoiesis , Clin. Res. 8: 131, 1960. 27. Rosenbach, L. M.; Caviles, A. P., and Mitus, W. J.: Chloramphenicol Toxicity: Reversible Vacuolization of Erythroid Cells , New Engl. J. Med. 263:724, 1960.Crossref 28. Jandl, J. H., and Greenberg, M. S.: Bone Marrow Failure Due to Relative Nutritional Deficiency in Cooley's Hemolytic Anemia: Painful "Erythropoietic Crises" in Response to Folic Acid , New Engl. J. Med. 260:461, 1959.Crossref 29. Oliner, H. L., and Heller, D.: Megaloblastic Erythropoiesis and Acquired Hemolysis in Sickle Cell Anemia , New Engl. J. Med. 261:19, 1959.Crossref 30. Jonsson, U.; Roath, O. S., and Kirkpatrick, C. I. F.: Nutritional Megaloblastic Anemia Associated with Sickle Cell States , Blood 14:535, 1959. 31. Chanarin, I.; Dacie, J. V., and Mollin, D. L.: Folic Acid Deficiency in Haemolytic Anemia , Brit. J. Haemat. 5:245, 1959.Crossref 32. Kunin, C. M.; Glazke, A. J., and Finland, M.: Persistance of Antibiotics in the Blood of Patients with Acute Renal Failure: II. Chloramphenicol, and Its Metabolic Products in the Blood of Patients with Severe Renal Disease or Hepatic Cirrhosis , J. Clin. Invest. 38:1498, 1959.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Erythropoietic Changes During Therapy with Chloramphenicol

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References (39)

Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1962.03620140048008
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Abstract

Abstract Anemic crises occur during the course of chronic hemolytic anemias, both congenital1-3 and acquired.4-6 These crises, due to temporary cessation of red cell production, are usually related to acute viral infections. Acute erythroblastopenia has also been reported in relation to treatment with various drugs, including chloramphenicol.7-10 The cases reported here are noteworthy for 4 reasons. First, they represent examples of anemic crisis occurring in the course of serious constitutional illnesses in which hemolysis did not seem to be important prior to the appearance of the crisis. Second, all 4 patients studied were receiving chloramphenicol at the time of development of erythroblastopenia. Third, striking "toxic" changes were noted in bone marrow cells at the height of the crisis in all 4 cases; changes of the type to be described have not been emphasized in most previous reports. Finally, in 1 of the 4 cases evidence has been obtained References 1. We are indebted to Dr. Herman W. Baker of The Mount Sinai Hospital, New York, for these determinations. 2. We are indebted to Dr. A. Leonard Luhby of the New York Medical College for these determinations. 3. The test is run over a 5-day period with the administration of 15 gm. of L-histidine monohydrochloride on the second, third and fourth days. 4. Owren, P. A.: Congenital Hemolytic Jaundice: The Pathogenesis of the "Hemolytic Crisis," Blood 3:721, 1948. 5. Singer, K.; Motulsky, A. G., and Wile, S. A.: Aplastic Crisis in Sickle Cell Anemia , J. Lab. Clin. Med. 35:721, 1950. 6. Dameshek, W., and Bloom, M. L.: The Events in the Hemolytic Crisis of Hereditary Spherocytosis with Particular Reference to Reticulocytopenia, Pancytopenia, and Abnormal Splenic Mechanism , Blood 3:1381, 1948. 7. Miesch, D. C.; Baxter, M. R., and Levin, W. C.: Acute Erythroblastopenia , A.M.A. Arch. Intern. Med. 99:461, 1957.Crossref 8. Chernoff, A. I., and Josephson, A. M.: Acute Erythroblastopenia in Sickle-Cell Anemia and Infectious Mononucleosis , A.M.A. Amer. J. Dis. Child. 82:310, 1951. 9. Crosby, W. H.: Paroxysmal Nocturnal Hemoglobinuria: A Report of a Case Complicated by an Aregenerative (Aplastic) Crisis , Ann. Intern. Med. 39:1107, 1953.Crossref 10. Osgood, E. E.: Hypoplastic Anemias and Related Syndromes Caused by Drug Idiosyncrasy , J.A.M.A. 152:816, 1953.Crossref 11. Volini, I. F.; Greenspan, I.; Ehrlich, L.; Gonner, J. A.; Felsenfeld, O., and Schwartz, S. O.: Hemopoietic Changes During the Administration of Chloramphenicol , J.A.M.A. 142:1333-1335, 1950.Crossref 12. Lindau, W.: Effect of Chloramphenicol upon Erythropoieses , in Proceedings of the American Federation for Clinical Research, Annual Meeting, Atlantic City, May, 1952 . 13. Krakoff, I. H.; Karnofsky, D. A., and Burchenal, J. H.: Effects of Large Doses of Chloramphenicol on Human Subjects , New Engl. J. Med. 253:7, 1955.Crossref 14. Erslev, A.: Hematopoietic Depression Induced by Chloromycetin , Blood 8:170, 1953. 15. Hodgkinson, R.: Blood Dyscrasias Associated with Chloramphenicol , Lancet 1:285, 1954.Crossref 16. Smiley, R. K.; Cartwright, G. E., and Wintrobe, M. M.: Fatal Aplastic Anemia Following Chloramphenicol Administration , J.A.M.A. 149: 914, 1952.Crossref 17. Rich, M. L.; Ritterhoff, R. J., and Hoffman, R. J.: A Fatal Case of Aplastic Anemia Following Chloramphenicol Therapy , Ann. Intern. Med. 33:1459, 1950.Crossref 18. Claudon, P. B., and Holbrook, A. A.: Fatal Aplastic Anemia Associated with Chloramphenicol Therapy , J.A.M.A. 149:912, 1952.Crossref 19. Sturgeon, P.: Fatal Aplastic Anemia in Children Following Chloramphenicol Therapy , J.A.M.A. 149:918, 1952.Crossref 20. Smith, R. M.; Joslyn, D. A.; Gruzhit, O. M.; McClean, W. I., Jr.; Penner, M. A., and Erlich, J.: Chloromycetin: Biological Studies , J. Bact. 55:425, 1948. 21. Cone, T. E., Jr., and Abelson, S. M.: Aplastic Anemia Following 2 Days of Chloramphenicol Therapy , J. Pediat. 41:340, 1952.Crossref 22. Ozer, F. L.; Truax, W. E., and Levin, W. C.: Erythroid Hypoplasia Associated with Chloramphenicol Therapy , Blood 16:997, 1960. 23. Smadel, J. E.: Chloramphenicol in the Therapy of Infectious Diseases , Amer. J. Med. 7:671, 1949.Crossref 24. Hargraves, M. M.; Mills, S. D., and Heck, F. J.: Aplastic Anemia Associated with the Administration of Chloramphenicol , J.A.M.A. 149: 1293, 1952.Crossref 25. Rubin, D.; Weisberger, A. S.; Botti, R. E., and Storaaski, J. P.: Changes in Iron Metabolism in Early Chloramphenicol Toxicity , J. Clin. Invest. 37:1286, 1958.Crossref 26. Saidi, P., and Wallerstein, R. O.: Effect of Chloramphenicol on Erythropoiesis , Clin. Res. 8: 131, 1960. 27. Rosenbach, L. M.; Caviles, A. P., and Mitus, W. J.: Chloramphenicol Toxicity: Reversible Vacuolization of Erythroid Cells , New Engl. J. Med. 263:724, 1960.Crossref 28. Jandl, J. H., and Greenberg, M. S.: Bone Marrow Failure Due to Relative Nutritional Deficiency in Cooley's Hemolytic Anemia: Painful "Erythropoietic Crises" in Response to Folic Acid , New Engl. J. Med. 260:461, 1959.Crossref 29. Oliner, H. L., and Heller, D.: Megaloblastic Erythropoiesis and Acquired Hemolysis in Sickle Cell Anemia , New Engl. J. Med. 261:19, 1959.Crossref 30. Jonsson, U.; Roath, O. S., and Kirkpatrick, C. I. F.: Nutritional Megaloblastic Anemia Associated with Sickle Cell States , Blood 14:535, 1959. 31. Chanarin, I.; Dacie, J. V., and Mollin, D. L.: Folic Acid Deficiency in Haemolytic Anemia , Brit. J. Haemat. 5:245, 1959.Crossref 32. Kunin, C. M.; Glazke, A. J., and Finland, M.: Persistance of Antibiotics in the Blood of Patients with Acute Renal Failure: II. Chloramphenicol, and Its Metabolic Products in the Blood of Patients with Severe Renal Disease or Hepatic Cirrhosis , J. Clin. Invest. 38:1498, 1959.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Feb 1, 1962

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