Agranulocytosis Following Administration of Phenylbutazone (Butazolidin®)

Phenylbutazone (butazolidin®) was introduced in America in The Journal for June 21, 1952. It seems to be of value in gout, in rheumatoid arthritis and a variety of rheumatoid disorders, and in psoriasis. It is important to remember that it is related chemically to aminopyrine (pyramidon®). In view of the fact that "among the 140 patients treated there was no instance of leukopenia," it seems important that the following unfortunate case should be reported promptly. REPORT OF CASE Rheumatoid arthritis developed in a 52-year-old white woman early in 1952. By May she was so badly disabled that cortisone was given in doses of 75 to 150 gm. daily, with only moderate improvement. On July 30 as moon facies had developed and the patient was almost completely bedridden, administration of phenylbutazone instead of cortisone was started. Her white blood cell count at this time was 8,750, with 68% segmented cells, 3%