title: Anaesthesia and congenital agranulocytosis: influence of anaesthetic agent on neutrophil numbers in a patient with Kostmann's syndrome.
abstract: We describe a 14-month-old male patient with congenital agranulocytosis who received general anaesthesia on three separate occasions during a 6-week period for minor surgery. Granulocyte colony stimulating factor was commenced after the second anaesthetic. Each anaesthetic was followed by profound reductions in neutrophil numbers, irrespective of the agent used. Even the third anaesthetic, which avoided all the common agents thought to have a marrow suppressant effect and given during granulocyte colony stimulating factor therapy, was associated with a marked decrease in neutrophil numbers.
authors.affiliation: Department of Anaesthesia, St George's Hospital, London.
authors.forename: S G
authors.initials: SG
authors.lastname: Fenner
authors.forename: J N
authors.initials: JN
authors.lastname: Cashman
mesh_terms: D000380:Agranulocytosis / Q000097:blood / Q000151:congenital* / Q000188:drug therapy; D000768:Anesthesia, General / Q000009:adverse effects*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000009:adverse effects; D007958:Leukocyte Count / Q000187:drug effects*; D008297:Male; D009504:Neutrophils / Q000187:drug effects*; D009609:Nitrous Oxide / Q000009:adverse effects
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D007649:Ketamine; D009609:Nitrous Oxide