Hattori Shuta, Kano Yosuke, Ichikawa Hiroshi, Muneoka Yusuke, Ishikawa Takashi, Ishikawa Hirosuke, Miura Kohei, Tajima Yosuke, Toshikawa Chie, Nakano Mae, Takizawa Kazuyasu, Nakano Masato, Shimada Yoshifumi, Sakata Jun, Wakai Toshifumi
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1817-1819.
A 71-year-old man with middle thoracic esophageal cancer was treated with neoadjuvant chemotherapy using docetaxel plus 5-FU plus cisplatin therapy and was also administered pegfilgrastim. Blood tests showed elevated white blood cell counts and C-reactive protein levels before the start of the third course. Contrast-enhanced computed tomography revealed wall thickening of the aortic arch. We diagnosed this as aortitis due to pegfilgrastim. Inflammation was improved with conservative treatment. We then performed video-assisted thoracoscopic esophagectomy. Drug-induced vasculitis should be included in the differential diagnosis of patients with elevated inflammation markers of unknown cause following the administration of granulocyte colony-stimulating factor preparations.
一名71岁的中胸段食管癌男性患者接受了多西他赛联合5-氟尿嘧啶加顺铂的新辅助化疗,并给予了培非格司亭。血液检查显示在第三疗程开始前白细胞计数和C反应蛋白水平升高。增强计算机断层扫描显示主动脉弓壁增厚。我们将此诊断为培非格司亭所致的主动脉炎。经保守治疗炎症得到改善。随后我们进行了电视辅助胸腔镜食管切除术。在给予粒细胞集落刺激因子制剂后,对于原因不明的炎症标志物升高的患者,药物性血管炎应纳入鉴别诊断。