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BMJ Case Rep ; 15(2)2022 Feb 03.
Article in English | MEDLINE | ID: covidwho-1673374


We present the case of a 62-year-old man with rheumatoid arthritis who developed a leukaemoid reaction and acute respiratory distress syndrome (ARDS) following granulocyte colony-stimulating factor (G-CSF) administration that had been given to treat neutropenia secondary to methotrexate and leflunomide toxicity. Later it was established that he had Pneumocystis jirovecii pneumonia, which was treated to complete resolution with a course of corticosteroids and antibiotics. This case highlights the potential risk of G-CSF administration in an immune compromised individual in the midst of bone marrow recovery in the context of active infection. Recognition of immune escape syndromes is vital and requires an understanding of potential triggers and risk factors.

Granulocyte Colony-Stimulating Factor/adverse effects , Neutropenia , Pneumonia, Pneumocystis , Respiratory Distress Syndrome , Humans , Leflunomide , Male , Methotrexate , Middle Aged , Pneumonia, Pneumocystis/complications , Pneumonia, Pneumocystis/diagnosis , Pneumonia, Pneumocystis/drug therapy , Respiratory Distress Syndrome/chemically induced , Respiratory Distress Syndrome/drug therapy
Br J Cancer ; 124(7): 1183, 2021 03.
Article in English | MEDLINE | ID: covidwho-1007651


The use of granulocyte colony-stimulating factor (G-CSF) in patients with haematological malignancies is associated with less febrile neutropenia episodes. But in the presence of COVID-19 infection, the administration of G-CSF is challenging as it may trigger a robust inflammatory reaction resulting in cytokine storm, respiratory failure and severe outcomes.

COVID-19/epidemiology , Granulocyte Colony-Stimulating Factor/administration & dosage , Hematologic Neoplasms/therapy , Hematopoietic Stem Cell Transplantation , COVID-19/complications , COVID-19/virology , Cytokine Release Syndrome/chemically induced , Granulocyte Colony-Stimulating Factor/adverse effects , Hematologic Neoplasms/complications , Humans , Prognosis , Respiratory Insufficiency/chemically induced , SARS-CoV-2/isolation & purification