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Abstract
Case Report
A case of chronic progressive pulmonary aspergillosis with voriconazole-induced agranulocytosis
Takatsune Hosoyaa,b Ryohei Nishinoa Ikuko Ookaa Masako Watanabea Tadashi Mizumotoa Fumihiro Sugaharaa
aDepartment of Respiratory Medicine, Hiroshima City North Medical Center Asa Citizens Hospital
bDepartment of Respiratory Medicine, Hiroshima University Hospital
ABSTRACT
A patient with chronic progressive pulmonary aspergillosis was treated with itraconazole (ITCZ). However, owing to difficulty in controlling the disease, the treatment was changed to voriconazole (VRCZ). Nevertheless, VRCZ had to be discontinued 2 months after this change owing to agranulocytosis. After temporary discontinuation, VRCZ was resumed after the patient’s neutrophil counts had recovered; however, agranulocytosis reappeared 2 months later. The diagnosis was idiosyncratic drug-induced agranulocytosis (IDIA) caused by VRCZ. After switching from VRCZ to ITCZ, agranulocytosis had not recurred after more than 6 months. This case indicates that VRCZ may cause agranulocytosis, and switching to other azoles may be effective in such cases.
KEYWORDS
Voriconazole (VRCZ) Chronic progressive pulmonary aspergillosis (CPPA) Idiosyncratic drug-induced agranulocytosis (IDIA)
Received 21 Nov 2023 ／ Accepted 11 Apr 2024
AJRS, 13(4): 175-179, 2024
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