"Hair-on-end" skull induced by long-term G-CSF treatment in severe congenital neutropenia.
"Hair-on-end" skull changes are typically seen in individuals suffering from thalassaemia. They are induced by widening of the diploic space due to marrow expansion that is a consequence of ineffective and excessive erythropoiesis. We present a child with severe congenital neutropenia who exhibited the typical hair-on-end sign on plain skull radiographs and MRI. In this patient the skull changes were very likely induced by the expansion of white blood cell precursors induced by long-term daily injections of recombinant human granulocyte colony stimulating factor (G-CSF) to treat his confounding disease. This case report is the first description of hair-on-end changes associated with the use of G-CSF.
Albert
Michael H
MH
Department of Haematology/Oncology, Dr. von Haunersches Kinderspital, Lindwurmstrasse 4, 80337 Munich, Germany. michael.albert@med.uni-muenchen.de
Notheis
Gundula
G
Wintergerst
Uwe
U
Born
Christine
C
Schneider
Karl
K
D002648:Child; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000151:congenital* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010024:Osteoporosis / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D011859:Radiography; D012886:Skull / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000187:drug effects*
D016179:Granulocyte Colony-Stimulating Factor