2024 Volume 42 Issue 2 Pages 222-227
Synopsis: A patient is a 52-year-old female with squamous cell carcinoma of uterine cervix. She underwent radical hysterectomy and turned out to be stage IIIC1 with left obturator lymph node metastasis. During her adjuvant chemotherapy, Pegfilgrastim was administered because of the duration of myelosuppression. 11 days after administration of anticancer agents, she had a fever and was admitted with urinary tract infection. Although her blood and urine cultures were negative, she was still febrile and her CRP level elevated. Contrast-enhanced CT revealed thickened wall of aortic arch. Autoimmune disease was ruled out and she was diagnosed as Pegfilgrastim induced aortitis. 14 days after administration of Pegfilgrastim, she became afebrile and her CRP level was normalized in natural course.
Granulocyte-colony stimulating factor (G-CSF) is used for treatment and prevention of febrile neutropenia. G-CSF induced aortitis was first reported in 2004 and added to a medical package insert as a severe adverse event in Japan. Infection is commonly suspected when a patient undergoing chemotherapy gets a fever, but it is important to consider aortitis if G-CSF was administered to them.
