|
Document Type |
: |
Article In Journal |
|
Document Title |
: |
HEMATOPOIETIC COLONY STIMULATING FACTORS CAN CAUSE CATARACT HEMATOPOIETIC COLONY STIMULATING FACTORS CAN CAUSE CATARACT |
|
Document Language |
: |
English |
|
Abstract |
: |
Background. Granulocyte-colony stimulating factor (G-CSF) is a lineage-restricted hematopoietic growth factor as it induces proliferation and maturation of neutrophilic precursors and progenitors, mobilizes myeloid progenitors into peripheral blood and activates neutrophil functions. Other cells like stromal cells and endothelial cells are activated too. It has been used to ameliorate or prevent profound neutropenia and its consequences. Congenital neutropenia such as Kotsmann’s or Schwachmann-Diamond syndromes are associated with severe neutropenia, which causes serious infectious complications that may be life threatening. CSF therapy in these disorders showed increased number of circulating neutrophils and improvement of infectious complications. Aim. Awareness of the uncommon side effect of high dose G-CSF. Method. Two-years-old boy who had repeated admission to the Hospital due to febrile illnesses and infection, associated with severe neutropenia in the range of 0.1-0.3¥109/L since early infancy. Bone marrow aspiration was consistent with the diagnosis of Kotsmann’s syndrome disease. Other reasons of neutropenia and immune deficiency were excluded. The patient received granulocyte-colony stimulating factor (G-CSF) and three times granulocytes monocytes-colony stimulating factor (GM-CSF) in a dose of subcutaneous 5 microgram/kilogram body weight (mcg/kg per day) during admission then once weekly for 7 months and neutrophil count was maintained in the range of 0.3 ' 0.6 ¥109/L. This dose was increased to 15 mcg/kg per day weekly but no increase in neutrophil count was observed. After 3 months of the high dose of the G-CSF, the patient developed bilateral eye cataract more at the left eye that required left lensectomy and its histological evaluation revealed chronic inflammation, many macrophages and some fibrosis and there were no positive cultures for the lens tissues. Discussion and Results. G-CSF can raise the granulocytes count and its usage is usually with febrile neutropenia and infections. The dose required for congenital neutropenia is usually 5-12 microgram/kg/day, the dose can be escalated until adequate response. Small number of patients experience bone pain during therapy. High dose of G-CSF can cause fever, rashes, pericarditis and pleural effusion. In chronic sitting, thrombocytopenia, splenomegaly, and vasculitis may be also seen at increased doses. GM-CSF is a potent hemopoietic cytokine that stimulates stem cell proliferation in the bone marrow and inhibits apoptotic cell death in leukocytes. Transgenic mice expressing a hemopoietic growth factor gene (GM-CSF) develop accumulations of macrophages, blindness, and a fatal syndrome of tissue damage. Summary. High dose of G-CSF can cause cataract. Regular opthalmological examination is needed. Higher dose need close follow-up. |
|
ISSN |
: |
0390-6078 |
|
Journal Name |
: |
Haematologica |
|
Volume |
: |
92 |
|
Issue Number |
: |
2 |
|
Publishing Year |
: |
1428 AH
2007 AD |
|
Article Type |
: |
Article |
|
Added Date |
: |
Sunday, August 30, 2009 |
|
Researchers
| سعاد الجاعوني | Al-Jaouni, Soad | Investigator | Doctorate | |
|