Drug-induced agranulocytosis treated with granulocyte-macrophage colony stimulating factor.
Drug induced agranulocytosis (DIA) is a potentially lethal disorder characterized by selective neutropenia. Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been utilized for its treatment. We report four cases of DIA treated with GM-CSF at the dose of 5 micrograms/kg/day. The patients presented infectious diseases at diagnosis. Median days to obtain 1 x 10(9)/L neutrophils and a normal neutrophil count (NNC), were 7(5-9) and 7.5 (6-10) days, respectively. The infectious disease at diagnosis improved and all patients are alive at the moment of this report. No other adverse effects than thrombocytosis (two cases) and thrombocytopenia (one case) were observed. We consider that GM-CSF could be a safe and effective alternative in the treatment of DIA.
Hurtado
R
R
Hematology Department, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Candelaria
M
M
Majluf-Cruz
A
A
Sosa-Camas
R E
RE
Labardini-Méndez
J
J
D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007958:Leukocyte Count; D008297:Male; D008713:Methimazole / Q000009:adverse effects; D009504:Neutrophils; D014069:Tonsillitis / Q000150:complications / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D007155:Immunologic Factors; D008713:Methimazole; D016178:Granulocyte-Macrophage Colony-Stimulating Factor