Tajiri J, Noguchi S, Murakami N
Tajiri Thyroid Clinic, Suizenji, Japan.
Thyroid. 1997 Aug;7(4):575-8. doi: 10.1089/thy.1997.7.575.
This prospective study was designed to investigate the usefulness of granulocyte count measurements 4 hours after injection of granulocyte colony-stimulating factor (G-CSF) for detecting recovery from antithyroid drug (ATD)-induced granulocytopenia or agranulocytosis. Granulocyte and white blood cell counts were measured 4 hours and 24 hours after patients with ATD-induced granulocytopenia had been given an injection of 75 micrograms of G-CSF (1.1 to 1.9 micrograms/kg; 1.5 +/- 0.2 micrograms/kg [mean +/- standard deviation]). Thirty-seven patients were studied and divided into three groups based on their initial granulocytopenic granulocyte count: 28 with mild (granulocyte count 0.501 to 1.0 x 10(9)/L), 6 with moderate (granulocyte count 0.101 to 0.5 x 10(9)/L), and 3 with severe (granulocyte count less than 0.1 x 10(9)/L) ATD-induced granulocytopenia. Twenty-five of the 28 patients with mild granulocytopenia and 4 of the 6 patients with moderate granulocytopenia were found to have recovered from the granulocytopenia both 4 hours and 24 hours after injection, and their granulocyte counts remained normal thereafter. However, the other 3 patients with mild granulocytopenia, 2 patients with moderate granulocytopenia, and all 3 patients with severe granulocytopenia had not recovered by either 4 or 24 hours after the G-CSF injection. Despite daily G-CSF injections, the granulocyte continued to decrease in most cases. It took 2 to 11 days for these counts to recover from granulocytopenia. These results indicate that granulocyte count measurement 4 hours after injection of G-CSF is useful for detecting recovery from ATD-induced granulocytopenia or agranulocytosis and for predicting disease severity. Accordingly, its measurement enables physicians to make an appropriate decision about whether a patient with ATD-induced granulocytopenia should be treated in the hospital or in the outpatient clinic.
本前瞻性研究旨在探讨注射粒细胞集落刺激因子（G-CSF）4小时后粒细胞计数测量对于检测抗甲状腺药物（ATD）所致粒细胞减少症或粒细胞缺乏症恢复情况的有用性。对ATD所致粒细胞减少症患者注射75微克G-CSF（1.1至1.9微克/千克；1.5±0.2微克/千克[均值±标准差]）后4小时和24小时测量粒细胞和白细胞计数。研究了37例患者，并根据其初始粒细胞减少时的粒细胞计数分为三组：28例轻度（粒细胞计数0.501至1.0×10⁹/L）、6例中度（粒细胞计数0.101至0.5×10⁹/L）和3例重度（粒细胞计数低于0.1×10⁹/L）ATD所致粒细胞减少症患者。28例轻度粒细胞减少症患者中的25例以及6例中度粒细胞减少症患者中的4例在注射后4小时和24小时均从粒细胞减少症中恢复，此后其粒细胞计数保持正常。然而，另外3例轻度粒细胞减少症患者、2例中度粒细胞减少症患者以及所有3例重度粒细胞减少症患者在G-CSF注射后4小时或24小时均未恢复。尽管每日注射G-CSF，但大多数情况下粒细胞仍持续减少。这些计数从粒细胞减少症恢复需要2至11天。这些结果表明，注射G-CSF后4小时测量粒细胞计数对于检测ATD所致粒细胞减少症或粒细胞缺乏症的恢复以及预测疾病严重程度是有用的。因此，其测量能够使医生就是否应将ATD所致粒细胞减少症患者收住入院或在门诊治疗做出适当决策。
