Cimetidine, Lupus Erythematosus, and Granulocytopenia

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To the editor: The association between cimetidine and agranulocytosis has recently been reviewed (1). We report a patient with systemic lupus erythematosus who developed this complication.

An 18-year-old Chinese woman with a 4-month history of Raynaud's phenomenon was admitted to another hospital on 29 December 1978 with fever, sore throat, photosensitivity rash, and a butterfly facial rash. The antinuclear antibody titre was 1:160 with an homogenous pattern, lupus erythematosus-cell phenomenon positive and DNA-binding 97%. Initial haemoglobin was 12.0 g/dL; platelet count, 137 000/mm3; and leukocyte count, 1500/mm3 with a normal differential (Figure 1). Bone-marrow examination on 8 January 1979 was

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