Colchicine
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Exacerbation of pancytopenia: case report A 49-year-old man exhibited exacerbation of pancytopenia during treatment with colchicine for constrictive pericarditis. The man, who was presented with dyspnea and presyncope, was hospitalised and diagnosed with constrictive pericarditis. Following clinical improvement, he was discharged on colchicine [dosage and route not stated] with concomitant ibuprofen. He was re-admitted thereafter. Investigations on readmission did not show further constrictive physiology; however, new transfusion-dependent, hypoproliferative macrocytic anaemia, thrombocytopenia and leucopenia were noted. Peripheral blood smear did not reveal dysplasia. Bone marrow biopsy, flow cytometry demonstrated left-shifted myeloid cells without increased blasts. Core biopsy described hypercellular marrow with morphology concerning for an underlying myeloid malignancy. Thereafter, the cell counts stabilised, and he was discharged with haematology follow-up. After 2 weeks, follow-up laboratory tests showed haemoglobin 7 [unit not stated]. He was sent to the emergency department, and a peripheral smear revealed 33% blasts. Repeat bone marrow biopsy showed acute myelogenous leukaemia. Eventually, a diagnosis of myelodysplastic syndrome with progression to acute myelogenous leukaemia was presumed. It was determined that the pancytopenia was due to underlying myelodysplastic syndrome, but the pancytopenia might have exacerbated by colchicine, leading to it’s early presentation in the form of symptomatic anaemia [duration of treatment to reaction onset not stated]. Author comment: "This patient’s pancytopenia was likely exacerbated by the use of colchicine and may have led to an earlier presentation due to symptomatic anemia." Nishtala A, et al. Don't leave me hanging out to dry. Journal of Hospital Medicine 13 (Suppl. 1): No. 4, Jan 2018. Available from: URL: https:// 803432324 www.journalofhospitalmedicine.com/jhospmed [abstract] - USA
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Reactions 9 Nov 2019 No. 1778
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