Despite the risk for numerous side effects, many side effects can be managed while continuing to take clozapine. Neutropenia and agranulocytosis
Clozapine Induced Neutropenia (CIN) occurs in approximately 3.8% of cases and Clozapine Induced Agranulocytosis (CIA) in 0.4%. These are potentially serious side effects and agranulocytosis can result in death. To mitigate this risk clozapine is only used with mandatory  absolute neutrophil count (ANC) monitoring (neutrophils are the most abundant of the granulocytes); for example, in the United States, the Risk Evaluation and Mitigation Strategy (REMS). The exact schedules and blood count thresholds vary internationally and the thresholds at which clozapine can be used in the U.S. has been lower than those currently used in the U.K. and Australasia for some time. The effectiveness of the risk management strategies used is such that deaths from these side effects are very rare occurring at approximately 1 in 7700 patients treated. Almost all the adverse blood reactions occur within the first year of treatment and the majority within the first 18 weeks. After one year of treatment these risks reduce markedly to that seen in other antipsychotic drugs 0.01% or about 1 in 10,000 and the risk of death is markedly lower still. When reductions in neutrophil levels are noted on regular blood monitoring then, depending on the value, monitoring may be increased or, if the neutrophil count is sufficiently low, then clozapine is stopped immediately and can then no longer be used within the medicinal licence. Stopping clozapine almost always results in resolution of the neutrophil reduction.
Pericardial cysts make up 6-7% of all mediastinal masses. They can present at any age, but are most commonly diagnosed between the third and fifth decade of life. Females and males have approximately equal incidences of pericardial cysts. History
Pericardial cysts were first reported on during autopsies in the 19th century by pathologists. As the field of radiology progressed, pericardial cysts could be identified in living patients. In 1931, the first surgical resection of a pericardial cyst was performed by Otto Pickhardt at Lenox Hill Hospital in New York using a thoracoscopy. In 1943, Greenfield and his colleagues coined the term "spring water cysts" for pericardial cysts since the cysts contain clear fluid. == References ==