Granulocyte Colony Stimulating Factor (G-CSF) can allow treatment with clozapine in a patient with severe Benign Ethnic Neutropaenia (BEN): a case report

Clozapine is the treatment of choice for treatment-resistant schizophrenia, but it is associated with a risk of neutropaenia and agranulocytosis. Clozapine use is regulated by mandatory blood monitoring in the UK, requiring cessation of treatment should the absolute neutrophil count (ANC) drop below...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of psychopharmacology (Oxford) Vol. 26; no. 9; pp. 1280 - 1282
Main Authors:	Spencer, Benjamin WJ, Williams, Hugh RJ, Gee, Siobhan H, Whiskey, Eromona, Rodrigues, Joseph P, Mijovic, Aleksandar, MacCabe, James H
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-09-2012 Sage Publications Sage Publications Ltd
Subjects:	Adult Adult and adolescent clinical studies African Continental Ancestry Group Antipsychotic Agents - adverse effects Antipsychotic Agents - therapeutic use Benign Biological and medical sciences Blood Case reports Clozapine Clozapine - adverse effects Clozapine - therapeutic use Colonies Drug Interactions Drug Monitoring Drug Resistance Filgrastim Granulocyte colony-stimulating factor Granulocyte Colony-Stimulating Factor - adverse effects Granulocyte Colony-Stimulating Factor - therapeutic use Humans Immunologic Factors - adverse effects Immunologic Factors - therapeutic use Leukocyte Count Leukocytes (granulocytic) Leukocytes (neutrophilic) Male Medical sciences Mental disorders Mental health care Neuropharmacology Neutropenia Neutropenia - chemically induced Neutropenia - drug therapy Neutropenia - ethnology Neutropenia - physiopathology Neutrophils - drug effects Neutrophils - immunology Pharmacology. Drug treatments Polyethylene Glycols Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychopharmacology Psychoses Recombinant Proteins - adverse effects Recombinant Proteins - therapeutic use Risk assessment Schizophrenia Schizophrenia - blood Schizophrenia - drug therapy Schizophrenia - immunology Severity of Illness Index Treatment Outcome United Kingdom Young Adult United Kingdom > UK clozapine BEN schizophrenia G-CSF Human Dibenzodiazepine derivatives Atypical antipsychotic Neuroleptic Psychotropic Cytokine Schizophrenia Clozapine Ethnic group Psychosis Case study Granulocyte colony stimulating factor D2 Dopamine receptor Treatment Antagonist
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Clozapine is the treatment of choice for treatment-resistant schizophrenia, but it is associated with a risk of neutropaenia and agranulocytosis. Clozapine use is regulated by mandatory blood monitoring in the UK, requiring cessation of treatment should the absolute neutrophil count (ANC) drop below specified values. Benign reductions in the ANC in non-white populations are common, and this can preclude a patient from receiving treatment with clozapine. A diagnosis of benign ethnic neutropaenia can reduce these treatment restrictions (UK specific), but the degree of neutropaenia can be significant enough to still prevent treatment. In this report, we show that response to granulocyte colony stimulating factor (G-CSF) may be quite variable and difficult to predict, but with careful monitoring it can be used to increase the ANC count and allow continued treatment with clozapine.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0269-8811 1461-7285
DOI:	10.1177/0269881112450782