KISEP Case Report 15 4 2004 올란자핀에 의해 유발되고 과립구 콜로니 자극 인자로 치료된 무과립구증 환자 1예 이원희 김 원 채정호 전태연 박원명 가톨릭대학교 의과대학 정신과학교실 ABSTRACT A Case of Agranulocytosis Induced by Olanzapine and Treated with Granulocyte-Colony Stimulating Factor Won-Hee Lee, MD, Won Kim, MD, Jeong-Ho Chae, MD, Tae-Youn Jun, MD and Won-Myong Bahk, MD Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea Agranulocytosis is a severe hematologic complication of clozapine, but olanzapine was not shown to induce agranulocytois. Nevertheless, some cases of olanzapine-induced agranulocytosis have been reported, but there was no report yet in Korea. Recently we experienced that a female patient taking olanzapine suffered by fever and aganulocytosis, so treated by discontinuation of olanzapine and granulocyte-colony stimulating factor G- CSF. A 35 year-old psychotic women started a treatment with olanzapine. At the 10th hospital day, 9 days after administration of olanzapine, agranulocytosis accompanied with fever developed and aggravated in spite of discontinuation of olanzapine. At the 12th hospital day, G-CSF was administered and the hematologic complication improved. Thereafter haloperidol and ECT was administerd for treatment of psychotic symptoms. At 80 hospital day, the patient discharged with normal hematologic profile and improved state of psychotic symptoms. Agranulocytosis induced by olanzapine is not frequent, but it can be developed in some vulnerable patients. So, if a patient taking olanzapine shows fever, chill and sore throat, hematologic examination should be carried out. Once agranulocytosis develops, immediate discontinuation of olanzapine and other potential drug is essential. Thereafter, preventive antibiotics and shortening in duration of aganulocytosis are needed. (Korean J Psychopharmacol 2004; 15(4):480-484) KEY WORDS:Olanzapine Agranulocytosis Granulocyte-colony stimulating factor. 서 교신저자 론 480
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482 고 찰 - - Korean J Psychopharmacol 2004;15(4):480-484
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