title: Profound thrombocytopenia related to G-CSF.
abstract: Severe thrombocytopenia in association with G-CSF therapy is extremely rare. Here we report a case of profound thrombocytopenia in a 57-year-old male with refractory cardiac ischemia, who received G-CSF during an angiogenesis trial. After 5 days of G-CSF therapy (10 microg/kg/day) the platelet count fell progressively to a nadir of 5x10(9)/L. The patient received steroid, immunoglobulin and platelet support and recovered without sequelae. Subsequent investigations suggested an underlying immune-mediated thrombocytopenia, which we hypothesize was exacerbated by G-CSF therapy.
authors.affiliation: The Victor Chang Cardiac Research Institute, St Vincent's Hospital, Faculty of Medicine, University of New South Wales, Australia.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Kovacic
authors.forename: Peter
authors.initials: P
authors.lastname: Macdonald
authors.forename: Judith
authors.initials: J
authors.lastname: Freund
authors.forename: John E J
authors.initials: JE
authors.lastname: Rasko
authors.forename: Roger
authors.initials: R
authors.lastname: Allan
authors.forename: Vivian B
authors.initials: VB
authors.lastname: Fernandes
authors.forename: David
authors.initials: D
authors.lastname: Ma
authors.forename: John
authors.initials: J
authors.lastname: Moore
authors.forename: Robert M
authors.initials: RM
authors.lastname: Graham
mesh_terms: D001772:Blood Cell Count; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000188:drug therapy / Q000276:immunology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced* / Q000276:immunology; D011994:Recombinant Proteins; D012720:Severity of Illness Index
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor