PDF(Pubmed)
Abstract：
Pegylated granulocyte colony-stimulating factor (G-CSF), commonly used in chemotherapy-induced neutropenia, has been associated with rare instances of aortitis. This study describes a 67-year-old female patient with estrogen receptor (ER)-positive, human epidermal growth factor receptor-2-positive breast cancer, undergoing chemotherapy with an epirubicin/cyclophosphamide (EC) regimen (epirubicin, cyclophosphamide) and pegylated G-CSF for neutropenia prophylaxis. Post-treatment, she developed symptoms including intermittent fever and severe arthralgia. Laboratory tests revealed an elevated white blood cell count, C-reactive protein levels, and erythrocyte sedimentation rate, while a computed tomography scan showed thickening in the aortic arch and descending aorta. Given the clinical presentation and exclusion of other potential causes, pegylated G-CSF-induced aortitis was suspected. The patient\'s symptoms improved significantly following the cessation of pegylated G-CSF, aiding in the differentiation from other types of aortitis. This study highlights the importance of considering pegylated G-CSF as a potential cause of aortitis in patients presenting with unexplained symptoms of fever and inflammation after chemotherapy. The rapid improvement upon discontinuation of the drug is a key feature distinguishing it from other aortitis causes. In conclusion, while rare, aortitis should be considered in the differential diagnosis of patients treated with pegylated G-CSF who exhibit relevant clinical symptoms. Early detection and management, including the discontinuation of the causative agent, are crucial for patient recovery and prognosis.
摘要：
聚乙二醇化粒细胞集落刺激因子（G-CSF），常用于化疗引起的中性粒细胞减少症，与罕见的主动脉炎有关。这项研究描述了一名67岁的女性患者，雌激素受体（ER）阳性，人表皮生长因子受体2阳性乳腺癌，正在接受表阿霉素/环磷酰胺（EC）方案的化疗（表阿霉素，环磷酰胺）和聚乙二醇化G-CSF用于预防中性粒细胞减少症。后处理,她出现了间歇性发热和严重关节痛等症状。实验室检查显示白细胞计数升高,C反应蛋白水平,和红细胞沉降率，而计算机断层扫描显示主动脉弓和降主动脉增厚。鉴于临床表现和排除其他潜在原因，怀疑聚乙二醇化G-CSF诱导的主动脉炎。停止聚乙二醇化G-CSF后，患者的症状显着改善，有助于区分其他类型的主动脉炎。这项研究强调了在化疗后出现无法解释的发烧和炎症症状的患者中，将聚乙二醇化G-CSF视为主动脉炎的潜在原因的重要性。停药后的快速改善是区别于其他主动脉炎原因的关键特征。总之,虽然罕见，对于出现相关临床症状的聚乙二醇化G-CSF治疗患者,在鉴别诊断中应考虑主动脉炎.及早发现和管理，包括停止病原体，对患者的康复和预后至关重要。
