Two patients taking procainamide developed agranulocytosis with septicaemia. Both recovered from the agranulocytosis, but one died of haemorrhagic pancreatitis and anuria. The latter had a strongly positive antinuclear antibody (A.N.A.) test. The frequency and relationship of the agranulocytosis and the lupoid syndrome caused by procainamide are briefly discussed. Precautionary measures for the early recognition of this grave hazard in exposed patients are advocated.
Get full access to this article
View all access options for this article.
References
1.
AntzisE., DunnJ. J., SchileroA. J. (1952). Pronestyl (procainamide) therapy in paroxysmal ventricular tachycardia. American Heart Journal43, 911
2.
BlomgrenS. E., CondemiJ. J., BignallM. C., VaughanJ. H. (1969). Antinuclear antibody induced by procainamide. A prospective study. New England Journal of Medicine, 281, 64
3.
Case Records of the Massachusetts General Hospital (1968). Skin rash and proteinuria after resection of carcinoma of the lung. New England Journal of Medicine, 278, 1167
4.
DuboisE. L. (1969). Procainamide induction of a systemic lupus erythematosus-like syndrome. Presentation of six cases, review of the literature, and analysis and follow-up of reported cases. Medicine (Baltimore), 48, 217
5.
FabregouleM., MesserschmittJ. (1954). Agranulocytose au cours d'un traitement par l'amide procainique. Le Sang, 25, 510
6.
FakhroA. M., RitchieR. F., LownB. (1967). Lupuslike syndrome induced by procainamide. American Journal of Cardiology, 20, 367
7.
GoodmanL. S., GilmanA. (1965). The Pharmacological Basis of Therapeutics, 3rd edition, p. 711. New York: MacMillan
8.
InouyeM., MillarJ., TownsendJ. H. (1951). Agranulocytosis following maintenance dosage of Pronestyl; report of severe case with recovery. Journal of the American Medical Association. 147, 652
9.
KrackeR. R., ParkerF. P. (1934). The aetiology of granulopenia (agranulocytosis) with particular reference to the drugs containing the benzene ring. Journal of Laboratory and Clinical Medicine, 19, 799
10.
LeeS. L., SiegelM. (1968). Drug Induced Diseases, volume 3, p. 243. (Excerpta Medica Foundation)
11.
MillerH., PollockR. C., GriffithG. C. (1951). Fatal agranuloctosis resulting from a procaine derivative. Journal of Laboratory and Clinical Medicine, 38, 850
12.
OsterZ. H. (1966). Agranulocytosis and lupus erythematosus phenomenon after procainamide. Israel Journal of Medical Science, 2, 354
13.
PisciottaA. V., KaldahlJ. (1962). Studies on agranulocytosis. IV. Effects of chlorpromazine on nucleic acid synthesis of bone marrow cells in vitroBlood, 20, 364
14.
RutherfordB. D. (1968). Procainamide-induced systemic lupus erythematosus. New Zealand Medical Journal, 68, 235
15.
SheldonP. J. H. S., WilliamsW. R. (1970). Procainamide-induced systemic lupus erythematosus. Annals of the Rheumatic Diseases, 29, 236
16.
TalmersF. N., TelmosA. J. (1965). A case report: Procainamide hydrochloride (Pronestyl) induced agranulocytosis. Journal of the Michigan Medical Society, 64, 655
17.
WangR. I., SchullerG. (1969). Agranulocytosis following procainamide administration. American Heart Journal, 78, 282
