Role of Glucocorticoids in Resolution of Granulocyte Colony Stimulating Factor–Induced Aortitis: 2 Cases and Review of the Literature

Abstract

Recombinant human granulocyte colony-stimulating factor (G-CSF) is widely established as primar or secondary prophylaxis against neutropenia for patients undergoing chemotherapy. Despite the common side effects being generally mild, some rare but severe adverse events have been docu mented. In recent years, increasing numbers of G-CSF-induced aortitis have been reported world wide. However, clinicians have not yet reached a consensus on the management and treatment of this condition. In this report, previously reported cases of G-CSF-induced aortitis in the literature are reviewed, and 2 additional independent cases are presented that share multiple common features regarding patient gender, age, G-CSF treatment regimen, imaging modalities for diagnosis, and disease course. In one of the cases, the patient was treated empirically with glucocorticoids, while in the other case, no spe cific treatment was given for the aortitis other than discontinuation of the G-CSF treatment. In both cases, improvement of symptoms and complete resolution of the inflammation were achieved about 1 month after the disease onset. Aortitis is a rare but severe adverse event of G-CSF therapy and should be suspected upon relevant complaints, prompting rapid investigation. Although empirical use of glucocorticoids appears effi cient for the resolution of the inflammation and symptoms, no substantial differences in the disease course were obtained in comparison to spontaneous remission upon discontinuation of G-CSF.

Cite this article as: Pei N, Borg A, Dani L, Wiklander OP, Parodis I. Role of glucocorticoids in resolution of granulocyte colony stimulating factor–induced aortitis: 2 cases and review of the literature. Eur J Rheumatol. 2025, 12(4), 0137, doi: 10.5152/ eurjrheum.2025.24137.