2023 Volume 69 Issue 6 Pages 433-437
Granulocyte colony-stimulating factor (GCSF)-induced aortitis is a rare disease that occurs in the relatively acute phase after GCSF use and is diagnosed by computed tomography (CT) in many cases. The prognosis is generally good, and patients can be followed up without treatment, but if there is an aortic aneurysm or if the imaging findings worsen, consultation with a cardiovascular surgeon is necessary to prevent rupture of the aortic aneurysm. It is often difficult to differentiate GCSF-induced aortitis from other diseases, such as infectious aortitis. A 67-year-old man with laryngeal cancer T2N2bM0 Stage IVa had been treated with pegfilgrastim, a sustained-duration GCSF, during induction chemotherapy. Blood test two days after the administration of pegfilgrastim showed an unexplained high C-reactive protein (CRP) level. The patient was diagnosed with GCSF-induced aortitis after CT revealed periaortic inflammation. The high CRP level and periaortic inflammatory findings revealed by CT resolved spontaneously with no treatment. Long-term persistence of inflammation in the aorta leading to aortic dissection has been reported, so this is a disease requiring caution.
