International Journal of Hematology and TherapyInternational Journal of Hematology and TherapyInternational Journal of Hematology and TherapyInternational Journal of Hematology and Therapy2381-1404Ommega Online PublishersNew Jersey, USA66410.15436/2381-1404.16.009Research ArticleAgranulocytosis Associated with Trandolapril-Verapamil CombinationAgranulocytosis Associated with Trandolapril-Verapamil CombinationHabip Gedik 1Hamur State Hospital Internal Medicine Clinic Turkey 2Ankara University Faculty of Medicine Anesthesiology and ICM Department Turkey 3Department of Hematology Ministry of Health Istanbul Training and Research Hospital Turkey 4Department of Infectious diseases and Clinical Microbiology Ministry of Health Bak Auml plusmn rkoy Sadi Konuk Editor* E-mail: habipgedik@gmail.com
The authors have declared that no competing interests exist.
20160901201621IJHT-15-CR-664/00920112015060120162016Creative Commons Attribution LicenseThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. nbsp emsp emsp A number of medications have been implicated as potential causes of severe neutropenia or agranulocytosis A 66-year-old female patient was administered with verapamil-trandolapril for treatment of hypertension Over three years of verapamil- trandolapril treatment neutropenia developed Verapamil-trandolapril was switched to amlodipine and white blood cell count recovered within two months After a while amlodipine was switched to ramipril because of the pretibial edema a side effect of amlodipine over thirty days neutropenia developed once again Agranulocytosis is rarely seen due to angiotensin converting enzyme ACE inhibitors Therefore physicians should be aware of the potential side effects of ACE inhibitors and their combinations on blood cells especially neutrophils particularly in patients treated for a long time 10