Jain K K
Drug Safety Department, Hoffmann La Roche, Basel, Switzerland.
J Am Acad Dermatol. 1994 Aug;31(2 Pt 1):213-5. doi: 10.1016/s0190-9622(94)70149-0.
Several cases of cutaneous vasculitis have been reported in patients treated with granulocyte colony-stimulating factor (G-CSF).
The purpose of this study was to determine the prevalence of cutaneous vasculitis in patients receiving G-CSF therapy, causal relation to the drug, and possible pathomechanisms.
Review of the literature, retrieval of cases from the safety database of the manufacturer of G-CSF, and global assessment of the causal relation of the drug to adverse drug reactions were done.
Eighteen cases of cutaneous vasculitis were found, of which only three have been published. A skin biopsy was done in 12 and showed leukocytoclastic vasculitis. Although cutaneous vasculitis was rare in patients treated for neutropenia associated with malignant disease and chemotherapy, it occurred in 6% of the patients with chronic benign neutropenias. Cutaneous vasculitis usually followed the increase of absolute neutrophil count (ANC) and subsided after the decrease of ANC. There was no recurrence if ANC was kept below 800/mm3. The course of G-CSF was completed in most patients.
Cutaneous vasculitis should be recognized as an adverse reaction to G-CSF with low morbidity. It can be managed by reduction of dose or discontinuation of G-CSF therapy and use of topical steroids.
有几例接受粒细胞集落刺激因子（G-CSF）治疗的患者发生了皮肤血管炎。
本研究旨在确定接受G-CSF治疗的患者中皮肤血管炎的患病率、与药物的因果关系以及可能的发病机制。
对文献进行综述，从G-CSF制造商的安全数据库中检索病例，并对药物与药物不良反应的因果关系进行全面评估。
发现18例皮肤血管炎病例，其中仅3例已发表。12例进行了皮肤活检，显示为白细胞破碎性血管炎。虽然在接受治疗的与恶性疾病和化疗相关的中性粒细胞减少症患者中皮肤血管炎很少见，但在慢性良性中性粒细胞减少症患者中发生率为6%。皮肤血管炎通常在绝对中性粒细胞计数（ANC）升高后出现，并在ANC降低后消退。如果ANC保持在800/mm3以下，则不会复发。大多数患者完成了G-CSF疗程。
应将皮肤血管炎视为G-CSF的一种不良反应，发病率较低。可通过减少剂量或停用G-CSF治疗以及使用局部类固醇来处理。
