BMJ Case Reports 2018; doi:10.1136/bcr-2017-222561
  • Unexpected outcome (positive or negative) including adverse drug reactions

Spontaneous splenic rupture as a rare complication of G-CSF injection

  1. Charles Ricordel1,2
  1. 1Centre Hospitalier Universitaire de Rennes, Rennes, France
  2. 2Chemistry Oncogenesis and Stress Signaling, INSERM U1242, Universite de Rennes 1, Rennes, France
  1. Correspondence to Dr Hervé Lena, herve.lena{at}
  • Accepted 18 December 2017
  • Published 12 January 2018


Splenic rupture is an infrequent and underdiagnosed side effect of granylocyte colony-stimulating factor (G-CSF). We report the case of a 54-year-old woman with brain and bone metastasis in a lung adenocarcinoma who was admitted for faintness 28 days after a G-CSF injection. Abdominal CT scan confirmed the diagnosis of splenic rupture. A conservative treatment was chosen using a peritoneal cleansing during laparoscopic surgery. Clinicians should be aware of this rare toxicity as it could be severe, but easily reversible using appropriate surgical treatment. Even if prognosis remains poor for patients with lung cancer, invasive procedures could be considered in this rapidly evolving setting, especially in case of reversible adverse event.


  • Contributors SB and HL contributed to conception and design of the manuscript. SB was responsible for the literature review. SB was responsible for clinical data collection. CR and FT were responsible for figures. All authors were responsible for manuscript editing and final approval of the article. CR takes responsibility for the paper as a whole.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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