A. GRAY ELLRODT, M.D.; GLEN H. MURATA, M.D.; MARY S. RIEDINGER, R.N.; MORGAN E. STEWART, M.S.; CAROL MOCHIZUKI, Pharm.D.; RICHARD GRAY, M.D.
Neutropenia is a rare complication of procainamide therapy. However, over a period of 20 months, 8 patients developed severe neutropenia while taking a sustained-release preparation of the drug. Seven patients presented with fever and constitutional symptoms and one patient was asymptomatic. Bone marrow examinations showed myeloid aplasia or maturation arrest in 5 patients and myeloid hyperplasia in 1. Neutropenia resolved within 30 days of drug withdrawal, and all patients survived. A case-control study showed a significant association between sustained-release procainamide therapy and severe neutropenia in 5 of 114 patients (4.4%) recovering from open-heart surgery (Mantel-Haenszel chi square = 13.84; p < 0.001). Thus, life-threatening neutropenia may be common with sustained-release procainamide preparations.
ELLRODT AG, MURATA GH, RIEDINGER MS, STEWART ME, MOCHIZUKI C, GRAY R. Severe Neutropenia Associated with Sustained-Release Procainamide. Ann Intern Med. 1984;100:197–201. doi: 10.7326/0003-4819-100-2-197
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Published: Ann Intern Med. 1984;100(2):197-201.
Cardiology, Rhythm Disorders and Devices.
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