{"id":"2d5fd8d9-b58e-5e39-b8c7-ad3d5cdca449","stable_key":"f2ec2007-88ff-5a96-a73b-8b5085e9cea9:mbz-neutropenia-with-the-benefit","predicate":"causes","statement":"Two patients on high-dose oral mebendazole for echinococcosis developed severe reversible neutropenia apparently due to marrow suppression, with platelets and red cells also reversibly suppressed in one, high blood levels of 239 nanograms per millilitre in one patient may have caused the neutropenia and several toxic side effects as well as a striking shrinkage of that patient’s pulmonary and liver cysts, neutropenia with high-dose therapy may occur in up to 5% of patients, and the white cell count should be monitored frequently during the first several weeks.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"positive","is_public":true,"mechanism_event_id":"98d688af-fc62-51f3-be50-a2747f0ebddc","mechanism_event_label":"The patient whose cysts shrank most was the patient whose marrow was suppressed.","subject":{"id":"f8582a13-fc2e-5127-a61f-5b0594e54069","slug":"mebendazole","display_name":"Mebendazole","entity_type_key":"drug"},"object":{"id":"e14cbf8c-7c12-5e4f-afd9-1efd24bb9da2","slug":"neutropenia","display_name":"Neutropenia from marrow suppression","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"98d688af-fc62-51f3-be50-a2747f0ebddc","stable_key":"f2ec2007-88ff-5a96-a73b-8b5085e9cea9:mbz-neutropenia-with-the-benefit-event","event_type":"observed_intervention","label":"The patient whose cysts shrank most was the patient whose marrow was suppressed.","description":"Two patients on high-dose oral mebendazole for echinococcosis developed severe reversible neutropenia apparently due to marrow suppression, with platelets and red cells also reversibly suppressed in one, high blood levels of 239 nanograms per millilitre in one patient may have caused the neutropenia and several toxic side effects as well as a striking shrinkage of that patient’s pulmonary and liver cysts, neutropenia with high-dose therapy may occur in up to 5% of patients, and the white cell count should be monitored frequently during the first several weeks.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"b3dedb88-ea6f-5178-ac07-17b1aa869d96","slug":"neutrophil","display_name":"Polymorphonuclear neutrophil","entity_type_key":"cell_type"},"role":"suppressed_cell","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"42246bab-bc05-54aa-bed7-28c5ea57976c","slug":"plasma-concentration","display_name":"Plasma concentration of mebendazole","entity_type_key":"cellular_process"},"role":"associated_measure","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"f8582a13-fc2e-5127-a61f-5b0594e54069","slug":"mebendazole","display_name":"Mebendazole","entity_type_key":"drug"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"e14cbf8c-7c12-5e4f-afd9-1efd24bb9da2","slug":"neutropenia","display_name":"Neutropenia from marrow suppression","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/mebendazole-research/6842806.abstract.txt\", \"locator\": \"Indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"bdad328a3c1865dc991e7d6825c6da6e68742c580b2f8e0d455635ab57e69031\", \"start_char\": 0, \"end_char\": 755, \"text_sha256\": \"bdad328a3c1865dc991e7d6825c6da6e68742c580b2f8e0d455635ab57e69031\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Case reports of two patients on high-dose oral mebendazole for echinococcosis","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"High-dose oral mebendazole, with a blood level of 239 nanograms per millilitre in one patient","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Two cases. The estimate that neutropenia may occur in up to 5% of patients is the authors’ judgement, not a measured rate from these two.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Mebendazole research collection; topical membership is not evidence of a direct clinical effect, and mebendazole is recorded separately from albendazole, from the benzimidazole class and from its own crystal forms.","comparator":null,"unit":null,"notes":"","entity":{"slug":"mebendazole","display_name":"Mebendazole","entity_type_key":"drug"}},{"dimension":"organism","value_text":"Human","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The patient whose cysts shrank most was the patient whose marrow was suppressed.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[mbz-p6842806] Severe, reversible neutropenia during high-dose mebendazole therapy for echinococcosis. (1983). https://pubmed.ncbi.nlm.nih.gov/6842806/ DOI: 10.1001/jama.1983.03330450059026","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Bone marrow","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"74583574-d9b7-5105-bedd-aebfb8bb8838","evidence_kind":"source_excerpt","locator":"Lines 628-639","start_line":628,"end_line":639,"excerpt":"### mbz-neutropenia-with-the-benefit\nTwo patients on high-dose oral mebendazole for echinococcosis developed severe reversible neutropenia apparently due to marrow suppression, with platelets and red cells also reversibly suppressed in one, high blood levels of 239 nanograms per millilitre in one patient may have caused the neutropenia and several toxic side effects as well as a striking shrinkage of that patient’s pulmonary and liver cysts, neutropenia with high-dose therapy may occur in up to 5% of patients, and the white cell count should be monitored frequently during the first several weeks.\nCondition category: biomarker_context\nnutrient_topic: Mebendazole research collection; topical membership is not evidence of a direct clinical effect, and mebendazole is recorded separately from albendazole, from the benzimidazole class and from its own crystal forms.\nplain_language: The patient whose cysts shrank most was the patient whose marrow was suppressed.\norganism: Human\ntissue_or_cell_type: Bone marrow\nexperimental_model: Case reports of two patients on high-dose oral mebendazole for echinococcosis\nlimitations: Two cases. The estimate that neutropenia may occur in up to 5% of patients is the authors’ judgement, not a measured rate from these two.\nexposure: High-dose oral mebendazole, with a blood level of 239 nanograms per millilitre in one patient\nevidence_span: {\"source_cache\": \"artifacts/mebendazole-research/6842806.abstract.txt\", \"locator\": \"Indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"bdad328a3c1865dc991e7d6825c6da6e68742c580b2f8e0d455635ab57e69031\", \"start_char\": 0, \"end_char\": 755, \"text_sha256\": \"bdad328a3c1865dc991e7d6825c6da6e68742c580b2f8e0d455635ab57e69031\"}\n[mbz-p6842806] Severe, reversible neutropenia during high-dose mebendazole therapy for echinococcosis. (1983). https://pubmed.ncbi.nlm.nih.gov/6842806/ DOI: 10.1001/jama.1983.03330450059026","model_system":"Case reports of two patients on high-dose oral mebendazole for echinococcosis","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [mbz-p6842806] Severe, reversible neutropenia during high-dose mebendazole therapy for echinococcosis. (1983). https://pubmed.ncbi.nlm.nih.gov/6842806/ DOI: 10.1001/jama.1983.03330450059026","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"06104773-03d0-5e5c-b9da-eb484e7be657","stable_key":"import-f2ec2007-88ff-5a96-a73b-8b5085e9cea9","title":"Mebendazole: the tubulin it binds, why that is selective, the crystal form that decides whether any of it works, and the off-target that became an oncology programme (2026-09-22)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"58b652636677e5033fd1dd555744485fcef18f21a97dcf68723fe072b656f413","revision_id":"a2cd9c22-0549-52ca-a653-8a0c2362ec85","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}