scholarly journals Ritodrine-Induced Agranulocytosis: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Atsushi Daimon ◽  
Misa Nunode ◽  
Takumi Sano ◽  
Tomohito Tanaka ◽  
Daisuke Fujita ◽  
...  

Ritodrine hydrochloride is used for preterm labor, although serious side effects, including agranulocytosis, are reported. We report a case of ritodrine hydrochloride-induced agranulocytosis accompanied by bacteremia due to catheter infection. At 24 weeks of gestation, a female patient presented due to threatened premature labor and was administered continuous intravenous infusion of ritodrine hydrochloride. On day 36 after starting intravenous ritodrine hydrochloride, she was diagnosed with agranulocytosis. The white blood cell and granulocyte count nadirs were 1,660/μl and 438/μl. The cumulative dose of ritodrine hydrochloride was 2,610 mg. Ritodrine therapy was immediately stopped, and she was given an intravenous injection of antibiotics and granulocyte colony-stimulating factor. From her blood culture, methicillin-sensitive Staphylococcus aureus was detected. However, she started vaginal delivery two days after we stopped the ritodrine infusion. When using ritodrine hydrochloride, it is necessary to frequently check the white blood cell count, regardless of the total dose and treatment period.

2018 ◽  
Vol 58 (7) ◽  
pp. 1218
Author(s):  
R. I. T. P. Batista ◽  
J. M. G. Souza-Fabjan ◽  
D. Í. A. Teixeira ◽  
L. M. Melo ◽  
V. J. F. Freitas

To ensure that animal welfare requirements and phenotypic characteristics of the newly produced transgenic lines are not compromised, an evaluation of all individuals is necessary. This can be inferred by the analysis of the growth and reproduction parameters. The present study was designed to determine the impact of the insertion of human granulocyte-colony stimulating factor (hG-CSF) transgene on growth and reproductive characteristics in first-generation (F1) goats from two transgenic lines. Bodyweight (BW) development (BW at birth, mean BW gain before weaning, BW at weaning, mean BW gain after weaning, BW at puberty), as well as reproductive parameters (age at puberty, ejaculate volume, concentration, total sperm per ejaculate, massal motility, progressive individual motility, major and minor defects) were similar (P > 0.05) between transgenic (T) and non-transgenic (NT) goats. Significant (P < 0.05) differences in mean (±s.d.) white blood cell count were observed between T and NT in first day of life (174.6 ± 14.7 × 103 and 15.0 ± 4.0 × 103 cells/µL), and during (66.8 ± 21.1 × 103 and 17.0 ± 4.6 × 103 cells/µL) and after (36.6 ± 4.0 × 103 and 15.5 ± 2.2 × 103 cells/µL) suckling, even though hG-CSF has not been detected in blood serum in any analysis. Although other cell counts were occasionally higher in T animals, differential counts showed that this difference was mainly due to an increased number of neutrophils, which represents 84.6%, 67.2% and 56.8% of total white blood cell count respectively, in the three time periods. Kidney and liver biochemical analyses indicated that all goats were healthy. Thus, it is possible to assume that all animals are normal and had no deleterious effects on either growth or reproductive parameters by the presence of transgene or as a consequence of leukocyte profile alteration.


2018 ◽  
Vol 25 (4) ◽  
pp. 869-874 ◽  
Author(s):  
Eiseki Usami ◽  
Michio Kimura ◽  
Mina Iwai ◽  
Makiko Go ◽  
Hiroki Asano ◽  
...  

Introduction Pegfilgrastim is a PEGylated formulation of filgrastim with a long half-life. It is highly convenient and less burdensome for patients. However, white blood cell count may temporarily increase after administration; in particular, a leukocyte overshoot may be observed. The present study retrospectively examined the incidence and timing of leukocyte overshoot after pegfilgrastim administration. Patients and methods Fifty-five patients (118 occasions of pegfilgrastim) were evaluated. Leukocyte overshoot was defined as white blood cell count ≥10,000/mm3 exceeding the reference value. Results Leukocyte overshoot was observed in 71.2% (84/118) occasions, in 76.4% (42/55) patients. The maximum white blood cell count ≥30,000/mm3 was observed in 30.5% (36/118) occasions in 45.5% (25/55) patients and was observed in 39.3% (33/84) occasions on day 1 after pegfilgrastim administration and 26.2% (22/84) on day 2. Leukocyte overshoot has been observed in only 23.1% (9/39) patients administered with normal granulocyte colony-stimulating factor. However, there were no patients with white blood cell counts ≥30,000/mm3. Conclusion There was a higher frequency of occurrence of leukocyte overshoot in response to pegfilgrastim than in response to normal granulocyte colony-stimulating factor. High incidence of leukocyte overshoot was observed when blood was collected 1–2 days after administration of pegfilgrastim. It is important for patients to understand the characteristics of pegfilgrastim by conducting pharmaceutical guidance.


2019 ◽  
Vol 12 (2) ◽  
pp. 603-607 ◽  
Author(s):  
Ryota Morinaga ◽  
Takashi Kawahara ◽  
Shinnosuke Kuroda ◽  
Yoshiaki Inayama ◽  
Hiroji Uemura

Granulocyte colony-stimulating factor (G-CSF)-producing bladder cancer is rare, with only 75 cases reported in Japan. A 67-year-old woman was referred to our institution for the further examination of gross hematuria. Cystoscopy revealed a 7-cm bladder tumor. The initial white blood cell count was 17,100/μL, and a transurethral resected specimen showed G-CSF expression. CT revealed that the tumor had invaded the colon. As the patient had uncontrollable schizophrenia, radical cystectomy was abandoned. We herein report a case of G-CSF-producing bladder tumor.


2021 ◽  
Vol 61 (5) ◽  
pp. 240-6
Author(s):  
Melek Buyukeran ◽  
Şule Yiğit ◽  
Hasan Tolga Çelik ◽  
Murat Yurdakök

Background Granulocyte-colony stimulating factor (G-CSF) is frequently used to treat neonatal neutropenia. There is a paucity of data in the literature on when immature to total neutrophil ratio (I/T ratio) can be accurately used as a sepsis marker after G-CSF therapy, as well as when I/T ratio returns to normal values expected in newborns who did not receive G-CSF. Objective To investigate changes in white blood cells counts and ratios in neonates with neutropenia before and after G-CSF therapy. Methods This retrospective study included newborns admitted to the NICU of Hacettepe University Ihsan Dogramaci Hospital, Ankara, Turkey, between 2005 and 2017 who received G-CSF therapy for neutropenia. Subjects underwent complete blood counts on the day before receiving G-CSF therapy (day 0) as well as days 1, 2, and 3 after treatment; I/T ratios were recorded from peripheral smears. Results Twenty-eight neonates were included in the study. Subjects’ median gestational age (interquartile range 25–75%) was 32.6 (29.7–37.6) weeks, and median birth weight was 1,630 (1,040–2,980) g. On day 3, there were significant increases in white blood cell counts compared to day 0. There were statistically significant elevations in the I/T ratios between day 0 and day 1 and between day 0 and day 2. On day 3, the I/T ratio decreased, but was not significantly different between day 0 and day 3. Conclusion The changes in I/T ratio observed after G-CSF treatments in our study suggest that the I/T ratio can be used as a reliable sepsis marker starting 72 hours after G-CSF administration. However, I/T ratio is significantly affected within 72 hours of G-CSF administration, and therefore, is unreliable as a sepsis marker during that period.


2011 ◽  
Vol 109 (suppl_1) ◽  
Author(s):  
Nobutake Shimojo ◽  
Takeshi Machino ◽  
Donzhu Xu ◽  
Taizo Kimura ◽  
Rumi Koshitsuka ◽  
...  

Introduction: Cardiac hypertrophy is an independent risk factor for sudden cardiac death from ventricular tachyarrhythmias (VT). Granulocyte colony-stimulating factor (G-CSF) has recently been reported to suppress VT after myocardial infarction by modulating the function of gap junctions between cardiomyocytes via maintaining Connexin-43 (Cx43). We hypothesized that the G-CSF could also regress an enhanced vulnerability to VT in the cardiac hypertrophy without ischemic fibrosis through regulating Cx43. Methods: Dahl salt-sensitive rats were maintained for a 6 week-period on a high-salt diet as left ventricular hypertrophy models (LVHs) and a low-salt diet as controls (CONs). After 3-time subcutaneous injection (50 μ g/kg) of G-CSF and vehicle, the inducibility of VT was evaluated by rapid ventricular burst pacing. The electrical pulses for the induction of VT were square waves with 6 ms width at 6 V and delivered at 25 Hz for 30 sec. White blood cell was counted to confirm a response to the G-CSF treatment. Expression levels of phosphorylated and total Cx43 in the rat ventricles were analyzed by immunoblotting. Results: The LVHs showed apparent cardiac hypertrophy without pathological fibrotic changes. The G-CSF reduced the inducibility of VT compared to the vehicle in the LVHs (11 % vs. 63 %, p=0.04). Furthermore, the G-CSF eliminated the inducibility of VT in the CONs, although a difference in the inducibility of VT between with and without the G-CSF treatment did not reach statistical significance in the CONs (0 % vs. 33 %, p=0.60). White blood cell count in one microliter of blood was elevated by the G-CSF treatment in both LVHs (15083±4397 vs. 6976±1308, p<0.01) and CONs (19370±1174 vs. 7700±2335, p<0.01). The G-CSF increased phosphorylated Cx43 levels compared to the vehicle in both LVHs (1.4-fold vs. 1.2-fold, p<0.01) and CONs (1.4-fold vs. 1.0-fold, p=0.04), whereas the G-CSF did not affect total Cx43 levels in all groups. Conclusion: We demonstrated that the G-CSF administration ameliorated the electrophysiological stability in the rat model of cardiac hypertrophy by modulating the function of gap junctions through accelerating phosphorylation of Cx43.


Blood ◽  
1991 ◽  
Vol 77 (12) ◽  
pp. 2597-2602 ◽  
Author(s):  
T Tanaka ◽  
T Suda ◽  
J Suda ◽  
T Inoue ◽  
Y Hirabayashi ◽  
...  

Abstract Granulocyte colony-stimulating factor (G-CSF) was reported to increase the number of colony-forming units-spleen (CFU-S) and multilineage colonies as well as myeloid-committed cells. We investigated the effects of G-CSF on myeloid progenitors and primitive stem cells in a mouse bone marrow transplantation (BMT) system. Lethally irradiated mice received BM cells from untreated or 5-fluorouracil-treated mice, and then were administered G-CSF or carrier buffer (control) for 5 days from immediately after BMT. A pre-CFU-S assay was performed by the repeated transplantation of BM cells from the first BMT recipients to other mice. By the method of polymerase chain reaction, most of the spleen colonies in the secondary recipients were confirmed to be derived from the first donors. G-CSF did not increase the peripheral white blood cell count significantly, but did increase the number of immature myeloid cells and granulocyte-macrophage colony-forming cells in the BM. The number of erythroid cells in the BM was initially suppressed and then increased by G-CSF treatment. In addition, the pre- CFU-S assay showed an increase in pre-CFU-S cells due to G-CSF administration. The number of spleen colonies of first BMT recipients did not increase, but a higher percentage of them were committed to a certain lineage by G-CSF treatment. These findings suggest that G-CSF has important roles in the early stages of hematopoiesis.


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