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Granulocyte colony stimulating factor-associated aortitis evaluated via multiple imaging modalities including
Mikiko Harada1, Hirohiko Motoki1, Takahiro Sakai1
1Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
European Heart Journal. Case Reports
|February 18, 2021
Summary
Granulocyte colony stimulating factor (G-CSF) can cause arteritis, a rare side effect. This case highlights using multiple imaging techniques, including vascular echography, for diagnosis and treatment guidance in G-CSF-associated aortitis.
Area of Science:
- Oncology
- Hematology
- Vascular Medicine
Background:
- Granulocyte colony stimulating factor (G-CSF) is used to treat chemotherapy-induced neutropenia.
- Arteritis is a recognized but rare side effect of G-CSF treatment.
- Limited reported cases hinder clear diagnostic criteria and treatment guidelines for G-CSF-associated arteritis.
Purpose of the Study:
- To present a case of G-CSF-associated aortitis.
- To illustrate diagnostic and treatment selection methods using multimodal imaging.
Main Methods:
- A 52-year-old woman with ovarian cancer received G-CSF for myelosuppression.
- Diagnostic workup included enhanced CT, aortic echography, MRI, and 18F-FDG PET.
- Diagnosis of G-CSF-associated aortitis was made after excluding other causes.
Main Results:
- The patient presented with persistent fever despite antibiotics and acetaminophen.
- Imaging revealed aortic wall thickening and inflammation.
- Corticosteroid treatment led to rapid clinical improvement.
Conclusions:
- Multimodal imaging, including vascular echography, is crucial for diagnosing G-CSF-associated aortitis.
- Differential diagnosis should include other large-vessel vasculitides, infections, and IgG4-related disease.
- Patient's overall condition must guide treatment selection.
