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A 62‐year‐old woman with cirrhosis of the liver developed fatal agranulocytosis while taking allopurinol. No precursors of granulocytes or red blood cells were found in bone marrow aspirated at the height of the reaction. The mechanism of agranulocytosis thus appeared to be suppression of granulocyte production rather than an increased rate of destruction of granulocytes. Possibly, allopurinol may have inhibited purine and pyrimidine biosynthesis in this patient.
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Greenberg et al. (1972) studied this question.
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