Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain.
Centro Integral Oncológico Clara Campal, Madrid, Spain.
Mod Rheumatol Case Rep. 2020 Jul;4(2):318-323. doi: 10.1080/24725625.2020.1754552. Epub 2020 Apr 30.
A 59 year-old woman was treated with adjuvant chemotherapy for triple negative breast cancer (TNBC) stage IB. She received pegfilgrastrim as secondary prophylaxis of neutropenia. After administration of pegfilgrastrim on day 11, she was hospitalised because of carotidynia and myocarditis that improved with antibiotics and steroids as an infection was suspected. Once she was recovered, another cycle of chemotherapy with pegfilgrastrim was administrated. At this time, the patient presented to our hospital with fever, odynophagia and chest pain, with diagnosis of myocarditis coupled with cardiogenic shock. She received antibiotics and steroids, advanced life support and also a pericardial window was done, with recovery of her condition. After a complete evaluation and exclusion of other possible aetiologies, we concluded that pegfilgrastrim was responsible for inducing carotidynia and myocarditis. Few cases have been published about Granulocyte-Colony stimulating factor (G-CSF) induced carotidynia and aortitis. However, this is the first reported case about G-CSF induced myocarditis and carotidynia.
一位 59 岁女性因三阴性乳腺癌（TNBC）IB 期接受辅助化疗。她接受培非格司亭作为中性粒细胞减少症的二级预防。在第 11 天给予培非格司亭后，因疑似感染，她因颈动脉痛和心肌炎住院，经抗生素和类固醇治疗后有所改善。一旦她康复，就进行了另一轮含培非格司亭的化疗。此时，患者因发热、咽痛和胸痛就诊于我院，诊断为心肌炎合并心源性休克。她接受了抗生素和类固醇治疗、高级生命支持治疗，还进行了心包开窗术，病情恢复。经过全面评估并排除其他可能的病因后，我们得出结论，培非格司亭导致了颈动脉痛和心肌炎。已有少数关于粒细胞集落刺激因子（G-CSF）引起的颈动脉痛和主动脉炎的病例发表。然而，这是首例关于 G-CSF 引起的心肌炎和颈动脉痛的报道。
