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Common Features in the Onset of ARDS After Administration of Granulocyte Colony-Stimulating Factor*

Hiroyuki Takatsuka, MD; Yoshinobu Takemoto, MD; Ako Mori, MD; Takahiro Okamoto, MD; Akihisa Kanamaru, MD; Eizo Kakishita, MD
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*From the Second Department of Internal Medicine (Drs. Takatsuka, Takemoto, Mori, Okamoto, and Kakishita), Hyogo College of Medicine, Hyogo; and Third Department of Internal Medicine (Dr. Kanamaru), Kinki University School of Medicine, Osaka, Japan.

Correspondence to: Hiroyuki Takatsuka, MD, Second Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinimiya, Hyogo, 663-8501, Japan; e-mail: hematol@hyo-med.ac.jp



Chest. 2002;121(5):1716-1720. doi:10.1378/chest.121.5.1716
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Study objective: Respiratory disturbance caused by ARDS has been reported during administration of granulocyte-colony stimulating factor. The clinical features of such respiratory distress were investigated in this study.

Design: Retrospective case review.

Setting: A 1,100-bed university teaching hospital.

Patients: Five patients who had dyspnea caused by ARDS develop after chemotherapy or bone marrow transplantation (BMT) at our hospital.

Interventions: None.

Measurement and results: Levels of cytokines, human leukocyte antigen (HLA) typing, and the clinical course were analyzed to clarify common features. All five patients possessed HLA-B51 or HLA-B52, and all had fever and an enhanced inflammatory response at the time of the WBC nadir. The tumor necrosis factor (TNF)-α and interleukin (IL)-8 levels increased when respiratory distress syndrome occurred.

Conclusions: If patients with HLA-B51 or HLA-B52 have infection develop at the time of WBC nadir after chemotherapy or BMT, ARDS may occur in association with elevation of TNF-α and IL-8 during WBC recovery.;1720>


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