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International Cancer Conference Journal

, Volume 8, Issue 2, pp 77–80 | Cite as

Acute arteritis after G-CSF administration

  • Yasuyuki Kinjo
  • Tomoko KuritaEmail author
  • Taeko Ueda
  • Seiji Kagami
  • Yusuke Matsuura
  • Kiyoshi Yoshino
Case report

Abstract

Granulocyte colony-stimulating factor (G-CSF) is commonly used in clinical practice to accelerate neutropenia recovery after chemotherapy. G-CSF is a myeloid growth factor produced by monocytes, macrophages, fibroblasts and endothelial cells. Generally, aortitis and arteritis are not a known side effect of G-CSF and is thought to be extremely rare. Here, we present a case of a 77-year-old woman who underwent adjuvant chemotherapy (combined paclitaxel and carboplatin) for ovarian cancer, and then developed acute arteritis after receiving G-CSF. She developed grade 4 neutropenia on day 7 of the third chemotherapy cycle and received six G-CSF administrations. Two days after G-CSF administration, she came down with a high-grade fever that persisted for 2 weeks. Laboratory tests revealed a white blood cell count of 8700 UI, neutrophilic sequestration of 61.5%, and C-reactive protein of 8.43 mg/dl at the highest point of her fever. Considering that we were initially treating neutropenia, we diagnosed a bacterial infection, and she was treated with a course of antibiotics. However, her blood and urinalysis cultures were negative, and antibiotics were ineffective; thus, we performed a computed tomography scan to search for the cause of her persistent fever. The computed tomography scan showed remarkable thickness of the bilateral common carotid artery and the left subclavian artery consistent with arteritis. With cessation of the antibiotics course, she was followed closely without therapy, and her condition resolved in a few days. We conclude that G-CSF induced arteritis due to our exclusion of other probable etiologies.

Keywords

Aortitis Arteritis G-CSF Side effect 

Notes

Acknowledgements

We thank James P. Mahaffey, PhD, from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

There is no editorial or financial conflict of interest among authors.

Compliance with ethical standards

Conflict of interest

All authors have no conflict of interest.

Consent for publication

The case report approval was obtained from the Hospital Research Ethics Board.

Informed consent

Informed consent was obtained from individual participants included in the study.

References

  1. 1.
    D’Souza A, Jaiyesimi I, Trainor L et al (2008) Granulocyte colony-stimulating factor administration: adverse events. Transfus Med Rev 22(4):280–290CrossRefPubMedGoogle Scholar
  2. 2.
    McMullin MF, Finch MB (1995) Felty’s syndrome treated with rhG-CSF associated with flare of arthritis and skin rash. Clin Rheumatol 14(2):204–208CrossRefPubMedGoogle Scholar
  3. 3.
    Hayat SQ, Hearth-Holmes M, Wolf RE (1995) Flare of arthritis with successful treatment of Felty’s syndrome with granulocyte colony stimulating factor (GCSF). Clin Rheumatol 14(2):211–212CrossRefPubMedGoogle Scholar
  4. 4.
    Iking-Konert C, Ostendorf B, Foede M et al (2004) Granulocyte colony-stimulating factor induces disease flare in patients with antineutrophil cytoplasmic antibody-associated vasculitis. J Rheumatol 31(8):1655–1658PubMedGoogle Scholar
  5. 5.
    Farhey YD, Herman JH (1995) Vasculitis complicating granulocyte colony stimulating factor treatment of leukopenia and infection in Felty’s syndrome. J Rheumatol 22(6):1179–1182PubMedGoogle Scholar
  6. 6.
    Vidarsson B, Geirsson AJ, Onundarson PT (1995) Reactivation of rheumatoid arthritis and development of leukocytoclastic vasculitis in a patient receiving granulocyte colony-stimulating factor for Felty’s syndrome. Am J Med 98(6):589–591CrossRefPubMedGoogle Scholar
  7. 7.
    Gornik HL, Creager MA. Aortitis (2008) Circulation 117(23):3039–3051CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Rojo-Leyva F, Ratliff NB, Cosgrove DM et al (2000) Study of 52 patients with idiopathic aortitis from a cohort of 1,204 surgical cases. Arthritis Rheum 43(4):901–907CrossRefGoogle Scholar
  9. 9.
    Darie C, Boutalba S, Fichter P et al (2004) Aortitis after G-CSF injections. Rev Med Interne 25(3):225–229CrossRefPubMedGoogle Scholar
  10. 10.
    Adiga GU, Elkadi D, Malik SK et al (2009) Abdominal aortitis after use of granulocyte colony-stimulating factor. Clin Drug Investig 29(12):821–825CrossRefPubMedGoogle Scholar
  11. 11.
    Miller EB, Grosu R, Landau Z (2016) Isolated abdominal aortitis following administration of granulocyte colony stimulating factor (G-CSF). Clin Rheumatol 35(6):1655–1657CrossRefPubMedGoogle Scholar
  12. 12.
    Sloand EM, Kim S, Maciejewski JP et al (2000) Pharmacologic doses of granulocyte colony-stimulating factor affect cytokine production by lymphocytes in vitro and in vivo. Blood 95(7):2269–2274PubMedGoogle Scholar

Copyright information

© The Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Yasuyuki Kinjo
    • 1
  • Tomoko Kurita
    • 1
    Email author
  • Taeko Ueda
    • 1
  • Seiji Kagami
    • 1
  • Yusuke Matsuura
    • 1
  • Kiyoshi Yoshino
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity of Occupational and Environmental HealthKitakyushuJapan

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