Granulocyte colony-stimulating factor-induced aortitis with temporal arteritis and monoarthritis.
Keisuke IidaYuki HondaYohichiro HommaPublished in: BMJ case reports (2023)
We present the case of a patient in his 80s receiving gemcitabine-cisplatin therapy for bladder cancer who developed neutropenia and was treated with filgrastim. In 10 days, the patient developed a mild fever with left jaw claudication and right knee arthritis. Contrast-enhanced CT findings indicated aortitis. Prednisolone was started for granulocyte colony-stimulating factor (G-CSF)-induced aortitis, and symptoms and elevated serum inflammatory markers resolved rapidly, allowing early discontinuation of prednisolone. Right knee arthritis relapsed at the initial follow-up. Contrast-enhanced CT revealed aortitis had disappeared. Therefore, recurrence of G-CSF-induced arthritis was suspected; prednisolone was resumed for 29 days without relapse. Most previous reports of G-CSF-induced aortitis have described inflammation of the aorta, carotid arteries and subclavian arteries; however, G-CSF-induced aortitis may present with more peripheral symptoms, such as temporal arteritis and knee arthritis. Furthermore, G-CSF-induced aortitis reportedly responds well and rapidly to prednisolone, although early discontinuation may lead to relapse.
Keyphrases
- contrast enhanced
- high glucose
- diabetic rats
- computed tomography
- magnetic resonance imaging
- rheumatoid arthritis
- magnetic resonance
- drug induced
- oxidative stress
- diffusion weighted
- endothelial cells
- total knee arthroplasty
- emergency department
- radiation therapy
- squamous cell carcinoma
- dual energy
- knee osteoarthritis
- acute myeloid leukemia
- coronary artery
- peripheral blood
- pulmonary hypertension
- locally advanced
- pulmonary artery
- sleep quality
- image quality