G-CSF ENHANCED GRANULOCYTE PRODUCTION IN A CHILD WITH SEVERE NEUTROPENIA IN THE SETTING OF FATAL VIRUS-ASSOCIATED HEMOPHAGOCYTIC SYNDROME

A 14‐year‐old boy with fatal varicella zoster virus‐associated hemophagocytic syndrome (VAHS) was treated with recombinant human granulocyte colony‐stimulating factor (G‐CSF) based on the finding that the patient had severe neutropenia and possible bacterial superinfection. Support for the G‐CSF therapy in VAHS is provided by the recent reports that G‐CSF is relatively specific for the granulocyte lineage; it would not activate mature monocyte/macrophage/histiocyte lineage in VAHS, where the most striking morphologic feature is histiocytic hyperplasia with hemophagocytosis. He responded well to G‐CSF with an elevation of neutrophil counts. There were no effects on other blood cells. The result indicates that G‐CSF is useful to increase granulocyte production in severe neutropenia, even in the setting of fatal VAHS. Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company