Migratory Aortitis Associated with Granulocyte-colony-stimulating Factor.

Area of Science:

• Vascular Medicine
• Oncology
• Rheumatology

Background:

• Granulocyte-colony-stimulating factor (G-CSF) is used to stimulate white blood cell production, often in cancer patients.
• Aortitis, inflammation of the aorta, can have various causes and presentations.
• The association between G-CSF and aortitis is not widely established.

Observation:

• A case of migratory aortitis developed in a 65-year-old woman with pancreatic cancer during pegfilgrastim (a form of G-CSF) treatment.
• The initial aortitis around the aortic arch resolved spontaneously but recurred in the descending aorta upon resuming pegfilgrastim.
• Three additional cases of G-CSF-induced aortitis were observed, all exhibiting spontaneous resolution.

Findings:

• G-CSF administration can induce aortitis, potentially presenting as a migratory pattern.
• Aortitis induced by G-CSF may resolve spontaneously.
• Recurrence of aortitis at different locations is possible after G-CSF re-administration.

Implications:

• G-CSF-induced aortitis might be self-limiting, potentially requiring minimal or short-term immunosuppression.
• Understanding this association is crucial for managing cancer patients receiving G-CSF.
• Further research is needed to elucidate the mechanisms and long-term outcomes of G-CSF-induced aortitis.