粒细胞缺乏症患者接受 G-CSF 治疗后发生危及生命的血小板增多症。

Life-threatening thrombocytosis following GCSF treatment in a case of clozapine-induced agranulocytosis.

机构信息

Assam Medical College, Dibrugarh, Assam, India.

出版信息

Gen Hosp Psychiatry. 2012 May-Jun;34(3):320.e1-2. doi: 10.1016/j.genhosppsych.2011.09.011. Epub 2011 Oct 21.

DOI:10.1016/j.genhosppsych.2011.09.011

PMID:22018773

Abstract

Clozapine was introduced in European market in 1972 as an effective treatment for schizophrenia without extrapyramidal side effects. Within a short while, the clozapine story virtually came to a halt following detection of life-threatening neutropenia and agranulocytosis. Judicial use of granulocyte colony stimulating factor (GCSF) can be life saving with infrequent side effects in these cases. Here we are presenting a case of clozapine induced agranulocytosis managed with GCSF but had transient but life-threatening thrombocytosis, a very uncommon complication of GCSF therapy. Expression of GCSF receptors on the surface of megakaryocytic lineage is thought to be the cause of this unusual phenomenon.

摘要

氯氮平于 1972 年在欧洲市场推出，作为一种治疗精神分裂症的有效药物，没有锥体外系副作用。然而，在发现其具有威胁生命的中性粒细胞减少症和粒细胞缺乏症后，氯氮平的应用几乎停滞不前。在这些情况下，粒细胞集落刺激因子（GCSF）的合理应用可以挽救生命，且副作用罕见。在这里，我们报告了一例氯氮平诱导的粒细胞缺乏症，用 GCSF 治疗，但出现短暂但危及生命的血小板增多症，这是 GCSF 治疗的一种非常罕见的并发症。推测 GCSF 受体在巨核细胞谱系表面的表达是这种异常现象的原因。