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[Streptomycin-induced severe aplastic anemia successfully treated with high-dose methylprednisolone pulse therapy and
1Department of Internal Medicine, Saga Prefectural Kohseikan Hospital.
Abstract:
An 83-year-old male was admitted with pulmonary tuberculosis. He was started on rifampicin, isoniazid, and streptomycin (SM). The hematological data at 12 weeks after the treatment showed pancytopenia (RBC: 2.14 x 10(6)/microliters, Hb: 7.2g/dl, Plt: 1.8 x 10(4)/microliters, WBC: 700/microliters). All the above medicines were discontinued and he received bolus methylprednisolone (bmPSL) and recombinant human granulocyte-colony stimulating factor (rhG-CSF). After 3 cycles of bmPSL, red blood cells and platelets gradually increased. White blood cells also increased in response to rhG-CSF. Bone marrow aspirate and biopsy specimens showed normocellularity, indicating recovery from aplastic anemia. Drug lymphocyte stimulation test was positive for SM.