G-CSF enhanced granulocyte production in a child with severe neutropenia in the setting of fatal virus-associated hemophagocytic syndrome.
A 14-year-old boy with fatal varicella zoster virus-associated hemophagocytic syndrome (VAHS) was treated with recombinant human granulocyte colony-stimulating factor (G-CSF) based on the finding that the patient had severe neutropenia and possible bacterial superinfection. Support for the G-CSF therapy in VAHS is provided by the recent reports that G-CSF is relatively specific for the granulocyte lineage; it would not activate mature monocyte/macrophage/histiocyte lineage in VAHS, where the most striking morphologic feature is histiocytic hyperplasia with hemophagocytosis. He responded well to G-CSF with an elevation of neutrophil counts. There were no effects on other blood cells. The result indicates that G-CSF is useful to increase granulocyte production in severe neutropenia, even in the setting of fatal VAHS.
Department of Pediatrics, Mie University School of Medicine, Japan.
E
E
Azuma
N
N
Tabata
T
T
Shibata
Y
Y
Komada
M
M
Ito
S
S
Atsumi
Y
Y
Kawasaki
M
M
Ishii
M
M
Sakurai
D000293:Adolescent; D001344:Autopsy; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006098:Granulocytes / Q000166:cytology*; D006410:Hematopoiesis / Q000187:drug effects; D015616:Histiocytosis, Non-Langerhans-Cell / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000150:complications*
D016179:Granulocyte Colony-Stimulating Factor