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Hyperacute leucopenia associated with furosemide
  1. Ben-Jiang Ma1,2
  1. 1IPC Healthcare/TeamHealth, Lake Mary, Florida, USA
  2. 2Florida Neurology, Lake Mary, Florida, USA
  1. Correspondence to Ben-Jiang Ma, benjiangma{at}


A 72-year-old man presented to the hospital with exacerbation of congestive heart failure. He was given furosemide 40 mg intravenously twice at 4 hours apart. At 4 hours after the second dose of furosemide, his white blood cells (WBC) dropped acutely from 9.8 to 2.4×109/L (reference range 4.1 to 9.3×109/L). With the discontinuation of furosemide, the WBC trended up to 7.1×109/L about 13 hours after the second dose of intravenous furosemide and remained in normal range for the next 3 days. However, when the oral furosemide was started on hospital day 4, there was a mild drop in WBC count, which returned to and maintained at baseline since the next day. The dynamic changes in the patient’s WBC were coincident with the use of furosemide. The possible mechanisms of furosemide-associated transient hyperacute leucopenia were discussed.

  • haematology (drugs and medicines)
  • cardiovascular system

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  • Contributors BJM is the corresponding author who contributed literature search, figures, data collection, data analysis, data interpretation and manuscript writing. BJM had full access to all the data in the study and had final responsibility for the decision to submit for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.