Euler H H, Harten P, Zeuner R A, Schwab U M
2nd Department of Internal Medicine, Christian-Albrecht University Kiel, Germany.
J Rheumatol. 1997 Nov;24(11):2153-7.
To investigate whether human recombinant granulocyte colony stimulating factor (GCSF) is capable of inducing increased neutrophil granulocyte (polymorphonuclear leukocytes, PMN) counts in patients with systemic lupus erythematosus (SLE) associated neutropenia and refractory infections.
Nine patients with SLE associated neutropenia and concomitant refractory infections received a total of 12 cycles of 48 Mio U GCSF per day subcutaneously for an average of 6 days (range 1-17 days) as an adjunct to antibiotic treatment. In one case of impaired wound healing, longterm GCSF was applied over 148 days.
In each case, the average PMN count increased distinctly within 2 days from 1.3 per nl (range 0.7-2.4) to 8.4/nl (3.2-19.4). Major adverse events were exacerbation of central nervous system symptoms in 2 patients and leukocytoclastic vasculitis in one.
GCSF induces a rapid increase in PMN counts in patients with lupus associated neutropenia and normal or hyperplastic granulopoiesis. In 3 of 9 patients we observed a flare of lupus associated symptoms.
研究重组人粒细胞集落刺激因子（GCSF）能否使系统性红斑狼疮（SLE）相关中性粒细胞减少及难治性感染患者的中性粒细胞（多形核白细胞，PMN）计数增加。
9例SLE相关中性粒细胞减少且伴有难治性感染的患者，作为抗生素治疗的辅助手段，接受了总共12个周期的皮下注射，每天4800万单位GCSF，平均6天（范围1 - 17天）。1例伤口愈合受损患者长期应用GCSF达148天。
在每例患者中，平均PMN计数在2天内明显增加，从每微升1.3（范围0.7 - 2.4）增至8.4/微升（3.2 - 19.4）。主要不良事件为2例患者出现中枢神经系统症状加重，1例出现白细胞破碎性血管炎。
GCSF可使狼疮相关中性粒细胞减少且粒细胞生成正常或增生的患者PMN计数迅速增加。9例患者中有3例出现狼疮相关症状的发作。
