G-CSF Treatment of Clozapine-Induced Agranulocytosis: A Case Report.
- Author:
Jun Suk LEE
1
;
Kwang Iel KIM
;
In Soon KIM
Author Information
1. Department of Neuropsychiatry, School of Medicine and The Mental Health Research Institute, Hanyang University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Clozapine;
G-CSF;
Agranulocytosis
- MeSH:
Agranulocytosis*;
Anti-Bacterial Agents;
Bone Marrow;
Bone Marrow Examination;
Clozapine;
Coinfection;
Communicable Diseases;
Diagnosis;
Granulocyte Colony-Stimulating Factor*;
Granulocyte-Macrophage Colony-Stimulating Factor;
Granulocytes;
Humans;
Korea;
Leukocytes;
Monitoring, Physiologic;
Specialization;
Stem Cells
- From:Journal of Korean Neuropsychiatric Association
1997;36(4):763-769
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The authors present a successful treatment case of clozapine-induced agranulocytosis with granulocyte colony-stimulating factor(G-CSF). It is the first case in Korea that occurred despite proper monitoring by the Clozaril patient Monitoring System(CPMS) and lull clinical vigliance. The mechanism of clozapine-induced agranulocytosis is unknown. Various studies are attempting to identity the pathogenic mechanism involved, and whether it is immunologic like human leukocyte antigen(HLA)-associated or toxic like desmethylclozapine-associated. However, it is clear that the final common pathway is suppression of myeloid proliferation in the bone marrow. The theory that clozapine-induced agranulocytosis Is caused by suppression of colony forming units of granulocytes and macrophages(CFU-GM) forms the rationale far the use of G-CSF or GM-CSF. The management of clozapine-induced agranulocytosis should include accurate diagnosis of agranulocytosis through bone marrow examinations, prompt discontinuation of clozapine, consultation with a hematologist, infectious disease specialist. Reverse isolation and administration of prophylactic antibiotics are need for prevention of secondary infection. A potential decrease of recovery time achieved by G-CSF obviously lowers the risk of secondary infectious disease.
