Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Treatment of severe neutropenia with high-dose pyridoxine in a patient with chronic graft versus host disease and squamous cell carcinoma: a case report. | Rauf et al. Journal of Medical Case Reports 2011 5 372 http content 5 1 372 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Treatment of severe neutropenia with high-dose pyridoxine in a patient with chronic graft versus host disease and squamous cell carcinoma a case report 1 2 2 2 2 Mariam Rauf Charise Gleason Ajay K Nooka Abbie Husman and Edmund K Waller Abstract Introduction The differential diagnosis of neutropenia includes medications infections autoimmune diseases and deficiencies of Vitamin B12 and folate. The association of Vitamin B6 deficiency with severe neutropenia is a rare finding. Case presentation A 51-year-old Caucasian woman presented with fever and profound neutropenia 48 neutrophils uL . Her clinical history included non-Hodgkin lymphoma in remission following treatment with allogeneic bone marrow transplantation quiescent chronic graft-versus-host disease and squamous cell carcinoma of the skin metastatic to cervical lymph nodes. Medications included atenolol topical clobetasol Ditropan oxybutynin prophylactic voriconazole prophylactic valganciclovir Soriatane acitretin and Carac fluorouracil cream. The bone marrow was hypocellular without metastatic cancer or myelodysplasia. Neutropenia did not respond to stopping medications that have been associated with neutropenia valganciclovir voriconazole and Soriatane or treatment with antibiotics or granulocyte colony stimulating factor. Blood tests revealed absence of antineutrophil antibodies normal folate and B12 levels moderate zinc deficiency and severe Vitamin B6 deficiency. Replacement therapy with oral Vitamin B6 restored blood vitamin levels to the normal range and corrected the neutropenia. Her cervical adenopathy regressed clinically and became negative on scintography following Vitamin B6 therapy and normalization of the blood neutrophil count. Conclusion Severe pyridoxine deficiency can lead to neutropenia. Screening for Vitamin B6 deficiency along .
