title: Favorable outcome of granulocyte colony-stimulating factor use in neuromyelitis optica patients presenting with agranulocytosis in the setting of rituximab.
abstract: Neuromyelitis optica is a severe autoimmune condition affecting the central nervous system characterized by a relapsing disease course. Rituximab is a chimeric monoclonal antibody against the protein CD20, and is one of the most utilized medications for management of this disease. A known complication of rituximab use is neutropenia. We report on two patients who developed symptomatic early-onset rituximab-induced agranulocytosis who safely received granulocyte colony-stimulating factor. Neutrophil counts recovered quickly and both patients continue to receive rituximab without further incident.
authors.affiliation: Johns Hopkins University, Department of Neurology, United States.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Mealy
authors.affiliation: Johns Hopkins University, Department of Neurology, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Levy
mesh_terms: D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D000069283:Rituximab / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors; D016179:Granulocyte Colony-Stimulating Factor; D000069283:Rituximab
keywords: Agranulocytosis; G-CSF; NMO; Neuromyelitis optica; Neutropenia; Rituximab