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Eur Respir J 2004; 23:649-650
Copyright ©ERS Journals Ltd 2004

G-CSF enables completion of tuberculosis therapy associated with iatrogenic neutropenia

L.J. Cormican1, S. Schey2 and H.J. Milburn1

1 Depts of Respiratory Medicine and 2 Haematology, Guy's Hospital, St. Thomas' Street, London, UK

CORRESPONDENCE: L.J. Cormican, Dept of Respiratory Medicine, Second Floor, Thomas Guy House, Guy's Hospital, St. Thomas Street, London, SE1 9RT, UK. Fax: 44 2079228206. E-mail: liam.cormican@gstt.sthames.nhs.uk

Keywords: Granulocyte-colony stimulating factor, neutropenia, tuberculosis

Received: May 13, 2003
Accepted October 6, 2003

Abstract

Neutropenia is a rare complication of anti-tuberculous therapy and is usually due to a single agent, most frequently isoniazid. The current case describes a previously healthy immunocompetent patient with tuberculosis of the lymph nodes who developed neutropenia due to a number of first line antibiotics (rifampicin, isoniazid and ethambutol) and streptomycin when introduced in combination and individually thus resulting in repeated treatment disruption.

The introduction of twice-weekly subcutaneous granulocyte-colony stimulating factor to correct iatrogenic neutropenia facilitated the continuation and eventual completion of therapy without adverse effect.

This is the first description of the use of granulocyte-colony stimulating factor to correct iatrogenic neutropenia due to anti-tuberculous antibiotics and the second description of the occurrence of iatrogenic neutropenia to more than anti-tuberculous antibiotic in an individual.






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