This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bonkowsky, J. L.
Right arrow Articles by Byington, C. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bonkowsky, J. L.
Right arrow Articles by Byington, C. L.

PEDIATRICS Vol. 109 No. 6 June 2002, pp. e98

ELECTRONIC ARTICLE

Metamizole Use by Latino Immigrants: A Common and Potentially Harmful Home Remedy

Joshua L. Bonkowsky, MD, PhD*, J. Kimble Frazer, MD, PhD*, Karen F. Buchi, MD*,{ddagger} and Carrie L. Byington, MD*,{ddagger},§

* Department of Pediatrics
{ddagger} Division of General Pediatrics
§ Division of Infectious Diseases and Geographic Medicine, University of Utah, Salt Lake City, Utah

--> A 4-year-old boy presented with fever, septic arthritis, and persistent neutropenia. Bone marrow biopsy revealed no evidence of neoplasia. Additional history disclosed that the patient had been given metamizole for pain before onset of his illness. Metamizole, a nonsteroidal antiinflammatory agent, is prohibited in the United States because of the risk of agranulocytosis but is widely used in Mexico and other countries. The increasing number of Latinos in the United States and the extensive cross-border transfer of medicines raise concerns that metamizole use and associated complications may become more frequent. After identification of the index patient, additional inquiry revealed that the patient’s mother was hospitalized previously for overwhelming sepsis associated with metamizole use. These cases prompted an investigation of metamizole use in an urban pediatric clinic, which revealed that 35% of Spanish-speaking Latino families had used metamizole; 25% of these families had purchased the medication in the United States. We conclude that metamizole use is common and may be underrecognized in immigrant Latino patients. Physicians in the United States, especially those who practice primary care, hematology/oncology, and infectious diseases, must be aware of the availability and use of metamizole in specific patient populations and its potential for harmful side effects.

Key Words: metamizole • neutropenia • home remedy

Abbreviations: WBC, white blood cell • ANC, absolute neutrophil count • G-CSF, granulocyte-colony stimulating factor

Received for publication Dec 28, 2001; Accepted Feb 14, 2002.