title: Hyperleucocytosis following G-CSF treatment for sulfasalazine-induced agranulocytosis.
abstract: Agranulocytosis is a rare but serious adverse effect of sulfasalazine treatment. We present a case of a 51-year-old woman receiving sulfasalazine for inflammatory arthritis presenting with sore throat, fever, lethargy and leucopenia (white cell count 0.9 × 10(9)/L). After 9 days of treatment with filgrastim (granulocyte-colony stimulating factor, G-CSF), her white cell count increased to 77.4 × 10(9)/L. This case highlights the importance of recognising sulfasalazine-induced agranulocytosis and the management of hyperleucocytosis following G-CSF treatment, to prevent harmful sequelae.
authors.affiliation: Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Chan
authors.affiliation: Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Redwan
authors.initials: R
authors.lastname: Farooq
mesh_terms: D000380:Agranulocytosis / Q000139:chemically induced / Q000188:drug therapy*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy; D005260:Female; D000069585:Filgrastim / Q000009:adverse effects* / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000209:etiology*; D008875:Middle Aged; D012460:Sulfasalazine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016179:Granulocyte Colony-Stimulating Factor; D012460:Sulfasalazine; D000069585:Filgrastim