Common features in the onset of ARDS after administration of granulocyte colony-stimulating factor.
OBJECTIVE
Respiratory disturbance caused by ARDS has been reported during administration of granulocyte-colony stimulating factor. The clinical features of such respiratory distress were investigated in this study.


METHODS
Retrospective case review.


METHODS
A 1,100-bed university teaching hospital.


METHODS
Five patients who had dyspnea caused by ARDS develop after chemotherapy or bone marrow transplantation (BMT) at our hospital.


METHODS
None.


RESULTS
Levels of cytokines, human leukocyte antigen (HLA) typing, and the clinical course were analyzed to clarify common features. All five patients possessed HLA-B51 or HLA-B52, and all had fever and an enhanced inflammatory response at the time of the WBC nadir. The tumor necrosis factor (TNF)-alpha and interleukin (IL)-8 levels increased when respiratory distress syndrome occurred.


CONCLUSIONS
If patients with HLA-B51 or HLA-B52 have infection develop at the time of WBC nadir after chemotherapy or BMT, ARDS may occur in association with elevation of TNF-alpha and IL-8 during WBC recovery.
Takatsuka
Hiroyuki
H
Second Department of Internal Medicine, Hyogo College of Medicine, Nishinimiya, Hyogo, Japan. hematol@hyo-med.ac.jp
Takemoto
Yoshinobu
Y
Mori
Ako
A
Okamoto
Takahiro
T
Kanamaru
Akihisa
A
Kakishita
Eizo
E
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects*; D015235:HLA-B Antigens / Q000032:analysis; D059949:HLA-B51 Antigen; D059950:HLA-B52 Antigen; D006801:Humans; D016209:Interleukin-8 / Q000097:blood / Q000502:physiology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000502:physiology
D000970:Antineoplastic Agents; D015235:HLA-B Antigens; D059949:HLA-B51 Antigen; D059950:HLA-B52 Antigen; D016209:Interleukin-8; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha; D016179:Granulocyte Colony-Stimulating Factor