Agranulocytosis related to vancomycin therapy.

A patient with renal failure due to Goodpasture's syndrome was treated with vancomycin. After he had received 3 g of the drug, his white blood cell count fell to a level of 200/microliter. Bone marrow biopsy disclosed severe myeloid hypoplasia. The patient subsequently recovered fully from this episode of vancomycin-induced agranulocytosis, but he eventually died of other causes. Vancomycin-related leukopenia has been reported, but the severely depressed white blood cell count and myeloid hypoplasia observed in this patient have not previously been described. Vancomycin must be excluded as the cause of leukopenia in any patient who is receiving this drug.