Serum concentrations of granulocyte colony-stimulating factor (G-CSF) in antithyroid drug-induced agranulocytosis.
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.
Murakami
Yasuhiro
Y
Comprehensive Medical Center for Health, Otemae Hospital, Osaka 584-0008, Japan.
Sasaki
Ichiro
I
Hiraiwa
Tetsuya
T
Arishima
Takeshi
T
Ito
Mitsuru
M
Hanafusa
Toshiaki
T
Sakane
Sadaki
S
Ohsawa
Nakaaki
N
Takamatsu
Junta
J
Miyauchi
Akira
A
Kuma
Kanji
K
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
D013956:Antithyroid Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D008713:Methimazole