Isolated abdominal aortitis following administration of granulocyte colony stimulating factor (G-CSF).
G-CSF is a myeloid growth factor produced by monocytes, macrophages, fibroblasts, and endothelial cells. Clinical uses of G-CSF includes mobilization of peripheral blood progenitor cells from healthy donors before hematopoietic stem cell transplantation, acceleration of neutrophil recovery following chemotherapy, and in the management of neutropenia due to other causes including AIDS and genetic disorders of granulocyte production. G-CSF is well tolerated and reports to be safe in healthy donors, although follow-up studies are limited in duration (D'Souza et al. in Transfus Med Rev 22(4):280-290, 2008).Isolated abdominal aortitis (IAA) is a rare disorder most commonly caused by the large-vessel vasculitides giant cell arteritis (GCA) and Takayasu arteritis, although it may also be associated with several other rheumatologic diseases and infections (Gornik and Creager in Circulation 117:3039-3051, 2008). To our knowledge, there only two cases have been published of IAA occurring in patients who had received G-CSF therapy (Dariea et al. in Rev Med Interne 25(3):225-229, 2004; Adiga et al. in Clin Drug Investig 29:821-825, 2009).We describe a case of a 55-year-old male, with peripheral vascular disease who after receiving Neupogen (G-CSF) developed a latent case of IAA. After further investigation and exclusion of other possible causative factors, we conclude that the most probable etiology is induction by G-CSF.
Division of Rheumatology and the Department of Internal Medicine D, Kaplan Medical Center, POB 1, Rehovot, 76100, Israel. Edward_m@clalit.org.il.|Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel. Edward_m@clalit.org.il.|Department of Internal Medicine "D", Kaplan Medical Center, Rehovot, Israel. Edward_m@clalit.org.il.
Edward B
EB
Miller
Division of Family Medicine and Primary Care, Clalit Health Services, Rishon-Le Ziyon, Israel.
Roy
R
Grosu
Department of Internal Medicine "D", Kaplan Medical Center, Rehovot, Israel.
Zvi
Z
Landau
D001025:Aortitis / Q000139:chemically induced* / Q000188:drug therapy*; D000072226:Computed Tomography Angiography; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*
D016179:Granulocyte Colony-Stimulating Factor; D011241:Prednisone
Aortitis; G-CSF; Granulocyte colony-stimulating factor