올란자핀에 의해 유발되고 과립구 콜로니 자극 인자로 치료된 무과립구증 환자 1예

A Case of Agranulocytosis Induced by Olanzapine and Treated with Granulocyte-Colony Stimulating Factor

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 simulating factor (GCSF) 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 earned 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)