Case of granulocyte colony-stimulating factor-induced Sweet's syndrome.
A 33-year-old male was referred with a two-week history of fevers to 40 degrees C and painful, erythematous skin and oral mucosal eruptions that had failed to respond to multiple anti-infectious agents. He had a recent diagnosis of a "myeloproliferative disorder with myelodysplastic features" on bone marrow biopsy, with associated pancytopenia. Two weeks before admission, he had been treated with a course of granulocyte colony-stimulating factor (G-CSF) at a dose of 300 microg/day in an attempt to improve his neutropenia. After four days of treatment, the fever and lesions developed. Infectious evaluation was negative; however, biopsies of the skin and oral mucosal lesions revealed histology consistent with Sweet's syndrome. Intravenous methylprednisolone (30 mg/day) was started with prompt defervescence and resolution of the lesions within days. With the increasing use of G-CSF, Sweet's syndrome is becoming more commonly recognized as an adverse effect. This is the first case of G-CSF-induced Sweet's syndrome to demonstrate gingival involvement.
Arbetter
K R
KR
Department of Internal Medicine, Mayo Graduate School of Medicine and Mayo Medical Center, Rochester, Minnesota, USA.
Hubbard
K W
KW
Markovic
S N
SN
Gibson
L E
LE
Phyliky
R L
RL
D000328:Adult; D005938:Glucocorticoids / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009503:Neutropenia / Q000628:therapy; D016463:Sweet Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology
D005938:Glucocorticoids; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D008775:Methylprednisolone