Granulocyte colony-stimulating factor-associated aortitis in a man with advanced prostate cancer

Granulocyte colony-stimulating factor-associated aortitis remains poorly understood among clinicians.

We present a case of G-CSF-associated aortitis in a 70-year-old male with stage IVb castration-resistant prostate cancer (cT3bN0M1b) receiving docetaxel chemotherapy. Neutropenia (280/μL) developed on day 8 of the first chemotherapy cycle, prompting subcutaneous administration of filgrastim, a short-acting G-CSF, on days 8-10. On day 14, the patient presented to the outpatient clinic with fever but no other significant symptoms. Computed tomography revealed filgrastim-induced thoracic aortitis. Daily prednisone treatment (equivalent to 25 mg prednisolone) was initiated on the following day. Although the initial episode of aortitis resolved within 5 weeks, subsequent pegfilgrastim resulted in recurrence around the left subclavian artery, necessitating further steroid therapy.

Persistent high fever following G-CSF administration may indicate drug-induced aortitis, highlighting the potential for aortitis recurrence with repeated G-CSF use.