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Ranitidine-Induced Granulocytopenia: Recurrence with Cimetidine Administration

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▸Requests for reprints should be addressed to Alan F. List, M.D.; Section of Hematology/Oncology, Veterans Administration Medical Center, 7th and Indian School Road; Phoenix, AZ 85012.

Phoenix Veterans Administration Medical Center and Good Samaritan Medical Center, Phoenix, Arizona

Ann Intern Med. 1988;108(4):566-567. doi:10.7326/0003-4819-108-4-566
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Drug-induced granulocytopenia occurs infrequently with Cimetidine administration (1). Ranitidine hydrochloride, the newest H2-antagonist in use, has gained widespread application because of its longer dosing interval and relative lack of serious adverse reactions (2). We report a case of reversible, ranitidine-induced granulocytopenia with bone marrow findings simulating those of acute promyelocytic leukemia that recurred after Cimetidine was administered.

A 61-year-old white man was hospitalized with fever and granulocytopenia on 10 October 1986. Five months earlier a craniotomy was done with partial resection of a grade IV astrocytoma. Postoperatively, the patient received 5000 rad wholebrain irradiation and phenytoin therapy, 300 mg daily,


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