Bone pain as an atypical early manifestation of acute myocardial infarction☆
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Neihu 114, Taipei, Taiwan
Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
Chih-Lu Han, PhD
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Neihu 114, Taipei, Taiwan
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Leone at al [1] have found a surge of serum level of endogenous granulocyte colony-stimulating factor (G-CSF) is in proportion to the circulation of CD34+ progenitor cells after acute myocardial infarction. This observation supported the notion that the myocardial regeneration commenced as early as the beginning of cardiomyocyte death in the form of motivating CD34+ progenitor cells from bone marrow in response to a variety of cytokines and G-CSF [2]. With clinical experience of the use of G-CSF administration, the side effect of severe bone pain is frequently encountered accounting for 1% to 5% of all cases.
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☆The authors declare no conflict of interests and no financial support from any institutes.
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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