Immune basis for cimetidine-induced pancytopenia
Nagler, A.; Rozenbaum, H.; Enat, R.; Tatarsky, I.; Katz, R.; Pollack, S.
American Journal of Gastroenterology 82(4): 359-361
1987
ISSN/ISBN: 0002-9270 PMID: 3471083 Document Number: 292981
We report a case of a female patient with chronic myelogenous leukemia who presented, 8 yr after initial diagnosis, with pancytopenia, encephalopathy, and myalgia. The tentative diagnosis was accelerated phase of chronic myelogenous leukemia. However, because the patient had been treated with cimetidine for 7 months we first omitted this drug. When cimetidine was stopped, bone marrow recovered, and myalgia and encephalopathy subsided. Immunological studies showed stimulation of the patient's lymphocyte blastogenesis by cimetidine and a marked increase in the proportion of cytotoxic/suppressor T lymphocytes after incubation of peripheral blood lymphocytes with cimetidine for 6 days. These findings indicate a role for cell-mediated immunity in the pathogenesis of cimetidine-induced pancytopenia in this patient.