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Titolo:
TREATMENT OF METHIMAZOLE-INDUCED AGRANULOCYTOSIS USING RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR (RHG-CSF)
Autore:
TAMAI H; MUKUTA T; MATSUBAYASHI S; FUKATA S; KOMAKI G; KUMA K; KUMAGAI LF; NAGATAKI S;
Indirizzi:
KYUSHU UNIV,FAC MED,DEPT PSYCHOSOMAT MED,HIGASHI KU,3-1-1 MAIDASHI FUKUOKA FUKUOKA 812 JAPAN KUMA HOSP KOBE HYOGO JAPAN NAGASAKI UNIV,SCH MED,DEPT INTERNAL MED 1 NAGASAKI 852 JAPAN UNIV CALIF DAVIS,SCH MED,DEPT INTERNAL MED SACRAMENTO CA 00000
Titolo Testata:
The Journal of clinical endocrinology and metabolism
fascicolo: 5, volume: 77, anno: 1993,
pagine: 1356 - 1360
SICI:
0021-972X(1993)77:5<1356:TOMAUR>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
DRUG-INDUCED AGRANULOCYTOSIS; GRAVES-DISEASE; PROPYLTHIOURACIL; CHEMOTHERAPY; NEUTROPENIA; COUNT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
H. Tamai et al., "TREATMENT OF METHIMAZOLE-INDUCED AGRANULOCYTOSIS USING RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR (RHG-CSF)", The Journal of clinical endocrinology and metabolism, 77(5), 1993, pp. 1356-1360

Abstract

Agranulocytosis, although extremely infrequent, is a serious complication of antithyroidal drug therapy in patients with hyperthyroidism. Presently, there is no specific therapy for this life-threatening complication, and recovery time is highly variable. Recently, recombinant human granulocyte colony-stimulating factor (rhG-CSF) was reported to be effective in shortening the recovery time of the neutropenia in patients undergoing chemotherapy. The present study was undertaken to determine the efficacy of rhG-CSF administration in patients with methimazole-induced (MMI) agranulocytosis. Thirty-four patients (7 males and 27 females, ages 16-68 yr) with MMI agranulocytosis were divided into 3groups: group A (n = 11) was treated with antibiotics only; group B (n = 11) received antibiotics and dexamethasone, 8 mg/day; and group C (n = 12) was treated with antibiotics and im injections of rhG-CSF, 75mu g/day. Patients in groups A and B were studied retrospectively. When rhG-CSF became available, patients in group C were studied prospectively. Bone marrow sternal punctures were performed in all group C patients who were then divided into 2 subgroups according to the granulocyte to erythrocyte count ratio (G:E). Group C-1 (n = 6) had a G:E ratio of less than 0.5, and group C-2 (n = 6) had a ratio of more than or equal to 0.5. Recovery time in all groups was defined as the number ofdays required for the peripheral granulocyte count to be greater than1.0 x 10(9)/L. There was no significant difference in recovery time between groups A and B: 10.1 +/- 2.2 and 12.3 +/- 1.9 days (mean +/- SE), respectively. P was not significant; the administration of dexamethasone proved to be ineffective in shortening the time for recovery from peripheral granulocytes. On the other hand, recovery time was significantly shorter in group C (6.8 +/- 1.2 days mean +/- SE) compared with groups A and B (P < 0.05). Group C-2 recovered in 2.2 +/- 0.6 days whereas group C-1 took much longer, 9.8 +/- 1.3 days (P < 0.001). Therewas a direct correlation between the G:E ratio and the peripheral leucocyte count, r = 0.806, P < 0.01. Furthermore, rhG-CSF significantly shortened recovery time when the peripheral granulocyte count was greater than 0.1 x 10(9)/L (group C-2) compared with patients whose countswere less than 0.1 x 10(9)/L (group C-l), 2.2 +/- 0.4 vs. 8.6 +/- 1.3days, respectively (P < 0.001). These data indicate that administration of steroids is ineffective in shortening the duration of recovery in patients with MMI agranulocytosis. Treatment with rhG-CSF significantly shortens recovery time if the peripheral granulocyte count is greater than 0.1 x 10(9)/L or if the total leucocyte count is greater than1.5 x 10(9)/L.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 21:45:50