Yamamoto Shintaro, Waki Daisuke, Maeda Takeshi
Department of Endocrinology and Rheumatology, Kurashiki Central Hospital, Kurashiki, JPN.
Department of Hematology and Oncology, Kurashiki Central Hospital, Kurashiki, JPN.
Cureus. 2021 Dec 21;13(12):e20563. doi: 10.7759/cureus.20563. eCollection 2021 Dec.
Granulocyte-colony stimulating factor (G-CSF) is widely used for preventing neutropenia, and large vessel vasculitis has been recognized as one of its severe adverse events. We report a case of diffuse large B-cell lymphoma in a 78-year-old woman in whom fever and right cervical pain developed after administration of filgrastim. Computed tomography and cervical artery ultrasound imaging revealed wall thickening in the right common carotid artery. We diagnosed her with G-CSF-induced vasculitis and administered prednisolone of 50 mg/day (1 mg/kg/day) to her. Her symptoms disappeared in a few days, and prednisolone was discontinued six weeks after initiation. G-CSF-induced vasculitis may be improved with short-term high-dose corticosteroids with rapid tapering.
粒细胞集落刺激因子(G-CSF)被广泛用于预防中性粒细胞减少,而大血管血管炎已被公认为是其严重不良事件之一。我们报告一例78岁女性弥漫性大B细胞淋巴瘤患者,其在使用非格司亭后出现发热和右侧颈部疼痛。计算机断层扫描和颈动脉超声成像显示右侧颈总动脉壁增厚。我们诊断她为G-CSF诱导的血管炎,并给予她50毫克/天(1毫克/千克/天)的泼尼松龙。她的症状在几天内消失,泼尼松龙在开始使用六周后停药。G-CSF诱导的血管炎可能通过短期大剂量皮质类固醇并快速减量得到改善。