GM-CSF-induced acute eosinophilic pneumonia.
There is increasing evidence that haemopoietic growth factors are effective in reversal of neutropenia associated with large granular lymphocytes (LGLs) proliferation. A 19-year-old woman with CD3+/TCR gamma delta+, CD4-, CD8- LGL proliferation and severe neutropenia repeatedly developed blood eosinophilia, fever and dyspnoea after administration of GM-CSF. Acute eosinophilic pneumonia with a lobar lung infiltrate pleural effusion, and marked bronchoalveolar lavage fluid eosinophilia was diagnosed. Treatment with corticosteroids and discontinuation of GM-CSF lead to rapid improvement. In addition, haematological analysis revealed that H*1 Technicon, a widely-used automated cell counter, may misinterpret eosinophils erroneously as neutrophils, therefore examination of blood smears to prevent eosinophil-mediated toxicity during GM-CSF treatment is recommended.
Seebach
J
J
Department of Internal Medicine, University Hospital Zurich, Switzerland.
Speich
R
R
Fehr
J
J
Tuchschmid
P
P
Russi
E
E
D000208:Acute Disease; D000328:Adult; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects*; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology; D011657:Pulmonary Eosinophilia / Q000209:etiology* / Q000473:pathology
D016178:Granulocyte-Macrophage Colony-Stimulating Factor