Aortitis after granulocyte-colony stimulating factor administration: A case report

Granulocyte-colony stimulating factor (G-CSF) is commonly used to reduce neutropenia-related complications following chemotherapy. It is a glycoprotein that stimulates the production of granulocytes [white blood cells (WBCs) in the bone marrow. In the present study, the case of a 59-year-old man is presented who received chemotherapy (eribulin) for liver metastases from sacral chordoma and subsequently developed acute aortitis after the administration of G-CSF. Grade 3 neutropenia occurred on day eight of the fifth chemotherapy cycle, and pegfilgrastim was administered on day nine. A total of 3 days after pegfilgrastim administration, the patient developed a fever that persisted for 6 days. He visited our hospital on day 18 with abdominal pain and elevated WBC count and C-reactive protein levels. Febrile neutropenia was suspected, and antibiotics were administered. However, both blood and urinalysis cultures returned negative results, and antibiotics were ineffective. Contrast-enhanced computed tomography revealed a thickened wall of the brachiocephalic artery and abdominal aorta, consistent with aortitis. After discontinuing the antibiotics, the patient was monitored closely without further treatment. His condition improved within a few days; therefore, it was concluded that aortitis was induced by G-CSF.