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Drug eruption caused by recombinant human G-CSF
O Sasaki1, A Yokoyama, S Uemura
1Second Department of Internal Medicine, Ehime University School of Medicine.
Internal Medicine (Tokyo, Japan)
|October 1, 1994
Summary
Systemic eruption can occur with both glycosylated and non-glycosylated recombinant human granulocyte colony-stimulating factor (rhG-CSF). Switching to an alternative rhG-CSF may be safe and effective if one causes a drug eruption.
Area of Science:
- Hematology
- Pharmacology
- Immunology
Background:
- Recombinant human granulocyte colony-stimulating factor (rhG-CSF) is crucial for managing neutropenia.
- Two primary forms exist: glycosylated (mammalian cell-derived) and non-glycosylated (E. coli-derived).
- Both rhG-CSF types are generally well-tolerated with minimal reported adverse effects.
Observation:
- Two patients developed systemic eruptions attributed to rhG-CSF treatment.
- These eruptions occurred despite the absence of detectable antibodies.
- The eruptions were associated with both glycosylated and non-glycosylated rhG-CSF formulations.
Findings:
- Drug eruptions can manifest with both types of rhG-CSF, irrespective of glycosylation.
- Intradermal skin testing can effectively identify the causative rhG-CSF agent.
- Cross-reactivity between rhG-CSF types is not absolute; switching may be feasible.
Implications:
- Clinicians should be vigilant for rhG-CSF-induced drug eruptions.
- Intradermal testing offers a diagnostic tool for rhG-CSF hypersensitivity.
- Alternative rhG-CSF formulations may provide a safer treatment option for patients experiencing eruptions.