title: Serum concentrations of granulocyte colony-stimulating factor (G-CSF) in antithyroid drug-induced agranulocytosis.
abstract: Granulocyte colony-stimulating factor (G-CSF) levels in serum were determined by a highly-sensitive chemiluminescent enzyme immunoassay (limit of detection, 0.5 pg/ml) in 54 patients with Graves' disease including 6 patients complicated with methimazole-induced agranulocytosis. Serum G-CSF levels in patients with Graves' disease were not different from normal subjects and did not correlate with serum FT4 level or circulating neutrophil counts. Before the onset of agranulocytosis, there was no difference in serum G-CSF level between the patients complicated with agranulocytosis and the uncomplicated patients. When circulating neutrophil counts decreased to less than 0.5 x 10(9)/L, serum G-CSF level elevated with the mean of 106.8 +/- 82.2 (SD) pg/ml, but the level did not correlate with the duration of agranulocytosis. Interestingly, maximum serum G-CSF level during the treatment with recombinant human G-CSF (100 microg/day) was related to bone marrow finding at the onset of agranulocytosis and correlated with the duration of agranulocytosis (r = 0.824, p < 0.05). In conclusion, measuring serum G-CSF levels with a highly-sensitive chemiluminescent enzyme immunoassay revealed that 1) thyrotoxicosis does not affect serum G-CSF level, 2) serum G-CSF level during antithyroid drug treatment does not play an important role in development of agranulocytosis, 3) the maximum serum G-CSF level in the course of agranulocytosis is related to the responsiveness of bone marrow to G-CSF and the recovery time from agranulocytosis.
authors.affiliation: Comprehensive Medical Center for Health, Otemae Hospital, Osaka 584-0008, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Murakami
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sasaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hiraiwa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Arishima
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ito
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
authors.forename: Sadaki
authors.initials: S
authors.lastname: Sakane
authors.forename: Nakaaki
authors.initials: N
authors.lastname: Ohsawa
authors.forename: Junta
authors.initials: J
authors.lastname: Takamatsu
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
authors.forename: Kanji
authors.initials: K
authors.lastname: Kuma
mesh_terms: D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001853:Bone Marrow / Q000276:immunology; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood* / Q000627:therapeutic use; D006111:Graves Disease / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D008713:Methimazole / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D013956:Antithyroid Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D008713:Methimazole