Ito Yuta, Noda Kentaro, Aiba Keisuke, Yano Shingo, Fujii Tsunehiro
Department of Diabetes, Endocrinology and Hematology, Fuji City General Hospital.
Department of Rheumatology, The Jikei University School of Medicine.
Rinsho Ketsueki. 2017;58(11):2238-2242. doi: 10.11406/rinketsu.58.2238.
A 59-year-old female with diffuse large B-cell lymphoma was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen. In addition, we administered pegfilgrastim for treating chemotherapy-induced febrile neutropenia. She complained of fever and neck and chest pain a few days after pegfilgrastim administration during the third and fourth courses of R-CHOP. Radiological imaging revealed an inflammation of large vessels, which led to the diagnosis of drug-associated vasculitis. We confirmed that vasculitis observed in this case was caused by pegfilgrastim administration because similar symptoms appeared with both injections of pegfilgrastim.
一名59岁的弥漫性大B细胞淋巴瘤女性患者接受了利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松龙(R-CHOP)方案治疗。此外,我们给予培非格司亭治疗化疗引起的发热性中性粒细胞减少症。在R-CHOP方案的第三和第四疗程中,她在接受培非格司亭治疗几天后出现发热、颈部和胸痛。影像学检查显示大血管炎症,从而诊断为药物相关性血管炎。我们确认该病例中观察到的血管炎是由培非格司亭给药引起的,因为两次注射培非格司亭均出现了类似症状。