Coronary thrombosis and thrombocytosis following subcutaneous injection of recombinant human granulocyte colony-stimulating factor injection
10.3760/cma.j.cn114015-20220524-00459
- VernacularTitle:重组人粒细胞刺激因子注射液致冠状动脉血栓形成和血小板增多
- Author:
Caiyun LI
1
;
Cheng XIE
;
Xiaolan ZHANG
Author Information
1. 苏州科技城医院药学部，苏州 215153
- Publication Type:Journal Article
- Keywords:
Granulocyte colony-stimulating factor;
Thrombosis;
Thrombocytosis;
Coronary thrombosis
- From:
Adverse Drug Reactions Journal
2023;25(4):250-252
- CountryChina
- Language:Chinese
-
Abstract:
A 23-year-old healthy male received subcutaneous injection of recombinant human granulocyte colony-stimulating factor injection (rhG-GSF) 600 μg once daily for 6 days before allogeneic hematopoietic stem cell transplantation as a donor. Before medication, there were no abnormalities in the patient′s coagulation markers, blood routine and biochemical tests, as well as electrocardiographic examination. Seven days after discontinuation of the drug, the patient developed sudden chest pain, sweating, and vomiting. Laboratory tests showed high sensitivity cardiac troponin T 3 144 ng/L, creatine kinase MB>300 μ G/L, myoglobin 505.6 μg/L, N-terminal pro-brain natriuretic peptido 1 138 ng/L, white blood cell count 17.7×10 9/L, platelet count 160×10 9/L. The electrocardiogram showed ST segment elevation myocardial infarction. A dual antiplatelet therapy of aspirin and ticagrelor was administered in conjunction with percutaneous transluminal coronary angioplasty. After surgery, anticoagulation, antiplatelet, and lipid-lowering treatments were given. On the 3rd day after surgery, the patient developed toe pain, fever, and a platelet count of 382×10 9/L, symptoms were gradually relieved after symptomatic treatment, but platelet count increased to 566×10 9/L. After consultation with hematologists and rheumatologists, combined with relevant laboratory test indicators, autoimmune and hematological system-related diseases were excluded. It was considered that coronary artery thrombosis and thrombocytosis may be related to the use of rhG-CSF, and platelet count gradually decreased to 275×10 9/L without special treatment. During the follow-up of 7 months, his platelet count was 235×10 9/L .
