Drug-induced thrombocytopenia during G-CSF therapy in a patient with chronic neutropenia

A one-year-old infant presented with recurrent perianal abscesses and pneumonia, and was diagnosed with chronic neutropenia. Treatment with granulocyte colony-stimulating factor (G-CSF) was initiated, and thrombocytopenia was detected three weeks later. The drug was discontinued but the patient's platelet count did not improve. A short course of high-dose methylprednisolone was administered, and both the platelet and neutrophil counts returned to normal. Based on this response, in order to maintain the neutrophil count the steroid treatment was continued for one year with tapered doses. At the time of writing, the patient had been doing well for 13 months without treatment. This report highlights that G-CSF treatment for severe chronic neutropenia in a child may be associated with thrombocytopenia.