顆粒球コロニー刺激因子が著効を示した薬剤性無顆粒球症

RAPID RECOVERY FROM DRUG-INDUCED AGRANULOCYTOSIS BY ADMINISTRATION OF G-CSF : A CASE REPORT

　64歳，女性．外陰癌術後のメチシリン耐性黄色ブドウ球菌感染症に対する抗菌化学療法中に，悪寒戦慄を伴う熱発と，白血球数700／mm3，好中球数0と無顆粒球症を認めた．イミペネム／シラスタチンによる薬剤性無顆粒球症を疑い，顆粒球コロニー刺激因子を投与開始した．投与2日後には白血球数3800／mm3，好中球数1710／mm3,5日後には白血球数8000／mm3，好中球数5700／mm3と著明に改善した．顆粒球コロニー刺激因子の薬剤性無顆粒球症に対する有用性が示唆された．

A 64-year-old woman with vulvar cancer was presented. Resection of the external genitalia and bilateral inguinal and external iliac lymph nodes, and cystostomy were performed. She had a sudden onset of septic fever with shaking chills on the 30th day during the consecutive administration of 2g/day of Imipenem/ Cilastatin for the wound infection of MRSA. Peripheral blood leukocytes was 700/mm3, with no neutrophils, 80/mm3 eosinophils, and 40/mm3 basophils. Diagnosis of bacteremia with concomitant drug-induced agranulocytosis was made, so the administration of Imipenem/Cilastatin was immediately discontinued.