Agranulocytosis and metamizole

: Among 78 000 patients hospitalized over a period of 11 years there were 12 with agranulocytosis drug- or allergy-induced. It is often difficult to be certain of the aetiology, because drug combinations or several drugs simultaneously are often prescribed. A definite relationship could not be proven, although it seemed possible, between six cases of agranulocytosis and the intake of metamizole. Taking into account two deaths and four relatively mild cases assumed to be the result of metamizole treatment, this incidence is similar to that reported in the literature. Alternative drugs have not been proven to cause fewer side-effects. These results suggest that there is no reason at present to stop the use of metamizole.