Anaesthesia and congenital agranulocytosis: influence of anaesthetic agent on neutrophil numbers in a patient with Kostmann's syndrome.

Abstract

We describe a 14-month-old male patient with congenital agranulocytosis who received general anaesthesia on three separate occasions during a 6-week period for minor surgery. Granulocyte colony stimulating factor was commenced after the second anaesthetic. Each anaesthetic was followed by profound reductions in neutrophil numbers, irrespective of the agent used. Even the third anaesthetic, which avoided all the common agents thought to have a marrow suppressant effect and given during granulocyte colony stimulating factor therapy, was associated with a marked decrease in neutrophil numbers.