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Related Experiment Videos

GM-CSF-induced acute eosinophilic pneumonia

J Seebach1, R Speich, J Fehr

  • 1Department of Internal Medicine, University Hospital Zurich, Switzerland.

British Journal of Haematology
|August 1, 1995
PubMed
Summary

Granulocyte-macrophage colony-stimulating factor (GM-CSF) can cause eosinophilic pneumonia in patients with large granular lymphocyte (LGL) proliferation. Careful blood smear examination is crucial to prevent toxicity during GM-CSF treatment.

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Area of Science:

  • Hematology
  • Pulmonology
  • Immunology

Background:

  • Large granular lymphocyte (LGL) proliferation is associated with neutropenia.
  • Haemopoietic growth factors, such as GM-CSF, are increasingly used to treat neutropenia.
  • The safety and potential adverse effects of GM-CSF in LGL proliferation require further investigation.

Observation:

  • A 19-year-old woman with CD3+/TCR gamma delta+, CD4-, CD8- LGL proliferation and severe neutropenia developed eosinophilia, fever, and dyspnea after GM-CSF administration.
  • The patient was diagnosed with acute eosinophilic pneumonia, characterized by lung infiltrates, pleural effusion, and bronchoalveolar lavage eosinophilia.
  • Automated cell counters (e.g., H*1 Technicon) may misinterpret eosinophils as neutrophils.

Findings:

  • GM-CSF treatment led to acute eosinophilic pneumonia in a patient with LGL proliferation.

Related Experiment Videos

  • Corticosteroid therapy and GM-CSF discontinuation resulted in rapid clinical improvement.
  • Manual blood smear examination is recommended to differentiate eosinophils from neutrophils during GM-CSF therapy.

    • Implications:

    • GM-CSF can induce severe pulmonary toxicity in specific patient populations.
    • Accurate differential blood counts are essential for managing patients receiving GM-CSF.
    • This case highlights the importance of vigilant monitoring for adverse effects of growth factor therapy.