RESUMO
We describe a case of histiocytic hemophagocytosis and increase in blasts in the bone marrow after administration of long acting G-CSF (pegfilgrastim) in a 71-year-old man with underlying myelodysplasia. Pegfilgrastim was discontinued, with resolution of the hemophagocytosis and marked decrease in blasts from 30 to 5%. We postulate that pegfilgrastim provided a continuous stimulation of the monocyte/macrophage system, resulting in histiocytic hemophagocytosis. We recommend caution in defining indications for the use of long acting preparations of G-CSF.
Assuntos
Fator Estimulador de Colônias de Granulócitos/efeitos adversos , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Histiocitose/induzido quimicamente , Histiocitose/patologia , Fagocitose/efeitos dos fármacos , Idoso , Biópsia , Filgrastim , Histiocitose/cirurgia , Humanos , Masculino , Defeitos do Tubo Neural/tratamento farmacológico , Defeitos do Tubo Neural/patologia , Polietilenoglicóis , Proteínas Recombinantes , Fatores de Tempo , Falha de TratamentoRESUMO
This report describes a visit by an international group interested in Rheumatology to the Rheumatology centers and traditional Chinese medicine units in the People's Republic of China. Differing disease patterns and treatment approaches offer opportunities for studies and collaborations. We can also learn from the traditional Chinese approach with individualization of therapy and attention to health maintenance.