title: Mesenteric vasculitis after G-CSF administration in a severe neutropenic patient with systemic lupus erythematosus.
abstract: Granulocyte colony-stimulating factor (G-CSF) is commonly used with neutropenic patients to accelerate recovery. G-CSF is a hematopoietic cytokine that regulates the proliferation and differentiation of neutrophil precursors, and is known as a safe and effective treatment for chemotherapy-induced neutropenia. However, we encountered a case in which a patient with systemic lupus erythematosus (SLE) developed mesenteric vasculitis after G-CSF administration. The patient was a 36-year-old female admitted with fever, arthralgia, and generalized erythematous rash. Despite symptomatic improvement with a high-dose steroid, severe neutropenia persisted for three weeks, precipitating a decision to use G-CSF to enhance recovery. Mesenteric vasculitis developed 15 hours after administration of G-CSF injection. Because the response of immune cells such as neutrophils and T cells is uncontrolled and dysfunctional in patients with lupus, G-CSF therapy should be used with caution.
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Y-G
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: S-R
authors.initials: SR
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: S-H
authors.initials: SH
authors.lastname: Hwang
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Jung
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: H-A
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea chsuh@ajou.ac.kr.
authors.forename: C-H
authors.initials: CH
authors.lastname: Suh
mesh_terms: D000328:Adult; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000188:drug therapy*; D008642:Mesenteric Veins / Q000187:drug effects; D009503:Neutropenia / Q000188:drug therapy*; D016896:Treatment Outcome; D014657:Vasculitis / Q000139:chemically induced*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor
keywords: Systemic lupus erythematosus; granulocyte colony-stimulating factor; mesenteric vasculitis; neutropenia