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Granulocyte colony-stimulating factor-induced aortitis with temporal arteritis and monoarthritis
  1. Keisuke Iida,
  2. Yuki Honda and
  3. Yoichiro Homma
  1. General Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
  1. Correspondence to Dr Keisuke Iida; dr.keisuke.iida.03{at}


We present the case of a patient in his 80s receiving gemcitabine-cisplatin therapy for bladder cancer who developed neutropenia and was treated with filgrastim. In 10 days, the patient developed a mild fever with left jaw claudication and right knee arthritis. Contrast-enhanced CT findings indicated aortitis. Prednisolone was started for granulocyte colony-stimulating factor (G-CSF)-induced aortitis, and symptoms and elevated serum inflammatory markers resolved rapidly, allowing early discontinuation of prednisolone. Right knee arthritis relapsed at the initial follow-up. Contrast-enhanced CT revealed aortitis had disappeared. Therefore, recurrence of G-CSF-induced arthritis was suspected; prednisolone was resumed for 29 days without relapse. Most previous reports of G-CSF-induced aortitis have described inflammation of the aorta, carotid arteries and subclavian arteries; however, G-CSF-induced aortitis may present with more peripheral symptoms, such as temporal arteritis and knee arthritis. Furthermore, G-CSF-induced aortitis reportedly responds well and rapidly to prednisolone, although early discontinuation may lead to relapse.

  • General practice / family medicine
  • Unwanted effects / adverse reactions
  • Rheumatology

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  • Contributors KI and YuH managed the case. YoH contributed to establishing the diagnosis. The manuscript was authored by KI. YuH and YoH reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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