Large-vessel vasculitis associated with PEGylated granulocyte-colony stimulating factor

Area of Science:

• Oncology
• Rheumatology
• Pharmacology

Background:

• Advanced endometrial cancer treatment often involves supportive care medications.
• Pegylated granulocyte-colony stimulating factor (G-CSF) is used to manage neutropenia in cancer patients.
• Drug-associated vasculitis is a known, albeit rare, complication of certain medications.

Observation:

• A 71-year-old female with advanced endometrial cancer received pegfilgrastim.
• Within seven days, the patient developed a fever.
• Imaging revealed rapidly progressive aortic wall thickening, indicative of vasculitis.

Findings:

• The clinical presentation suggests G-CSF-associated large-vessel vasculitis (LVV).
• This case illustrates a specific manifestation of G-CSF-induced vasculitis.
• Prompt recognition is crucial for appropriate patient management.

Implications:

• Clinicians should consider drug-associated vasculitis when patients on PEGylated G-CSF develop inflammatory symptoms.
• This case underscores the importance of monitoring for vascular complications during cancer therapy.
• Early diagnosis and management of G-CSF-associated LVV can prevent severe outcomes.