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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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G-CSF-induced Aortitis Mimicking TIPIC Syndrome.

Takao Nagashima1, Hiroki Yabe1, Yasunobu Sekiguchi2

  • 1Division of Rheumatology, First Department of Comprehensive Medicine, Jichi Medical University Saitama Medical Center, Japan.

Internal Medicine (Tokyo, Japan)
|May 7, 2025
PubMed
Summary
This summary is machine-generated.

A patient

Keywords:
TIPIC syndromecarotidyniagiant cell arteritisgranulocyte colony-stimulating factorlarge vessel vasculitis

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Area of Science:

  • Vascular Medicine
  • Oncoimmunology

Background:

  • Giant cell arteritis (GCA) and transient perivascular inflammation of the carotid artery (TIPIC) syndrome are inflammatory conditions affecting the carotid artery.
  • Granulocyte colony-stimulating factor (G-CSF) is used to stimulate white blood cell production, particularly in patients undergoing chemotherapy for conditions like malignant lymphoma.
  • Distinguishing between inflammatory arteritis and drug-induced vascular changes can be challenging in clinical practice.

Purpose of the Study:

  • To report a rare case of G-CSF-induced aortitis mimicking TIPIC syndrome in a patient with malignant lymphoma undergoing chemotherapy.
  • To highlight the importance of considering drug-induced vasculitis in the differential diagnosis of carotid artery inflammation.

Main Methods:

  • A 60-year-old woman with malignant lymphoma presented with symptoms suggestive of arteritis.
  • Diagnostic workup included computed tomography and ultrasonography of the neck to evaluate carotid artery inflammation.
  • Clinical course, symptom resolution, and temporal relationship with G-CSF administration were key factors in diagnosis.

Main Results:

  • Imaging revealed significant perivascular wall thickening of the right carotid artery, initially suggestive of GCA or TIPIC syndrome.
  • The patient's symptoms (fever, neck pain, swelling) resolved spontaneously and rapidly.
  • The onset of symptoms shortly after G-CSF administration led to the diagnosis of G-CSF-induced aortitis.

Conclusions:

  • G-CSF administration can induce aortitis that mimics inflammatory conditions like TIPIC syndrome.
  • This case underscores the need for careful consideration of iatrogenic causes of vasculitis, especially in immunocompromised patients.
  • Prompt recognition and understanding of G-CSF-induced aortitis are crucial for appropriate patient management and avoiding misdiagnosis.