Cutaneous vasculitis associated with granulocyte colony-stimulating factor. 1994

K K Jain
Drug Safety Department, Hoffmann La Roche, Basel, Switzerland.

BACKGROUND Several cases of cutaneous vasculitis have been reported in patients treated with granulocyte colony-stimulating factor (G-CSF). OBJECTIVE The purpose of this study was to determine the prevalence of cutaneous vasculitis in patients receiving G-CSF therapy, causal relation to the drug, and possible pathomechanisms. METHODS Review of the literature, retrieval of cases from the safety database of the manufacturer of G-CSF, and global assessment of the causal relation of the drug to adverse drug reactions were done. RESULTS Eighteen cases of cutaneous vasculitis were found, of which only three have been published. A skin biopsy was done in 12 and showed leukocytoclastic vasculitis. Although cutaneous vasculitis was rare in patients treated for neutropenia associated with malignant disease and chemotherapy, it occurred in 6% of the patients with chronic benign neutropenias. Cutaneous vasculitis usually followed the increase of absolute neutrophil count (ANC) and subsided after the decrease of ANC. There was no recurrence if ANC was kept below 800/mm3. The course of G-CSF was completed in most patients. CONCLUSIONS Cutaneous vasculitis should be recognized as an adverse reaction to G-CSF with low morbidity. It can be managed by reduction of dose or discontinuation of G-CSF therapy and use of topical steroids.

UI MeSH Term Description Entries
D009503 Neutropenia A decrease in the number of NEUTROPHILS found in the blood. Neutropenias
D011994 Recombinant Proteins Proteins prepared by recombinant DNA technology. Biosynthetic Protein,Biosynthetic Proteins,DNA Recombinant Proteins,Recombinant Protein,Proteins, Biosynthetic,Proteins, Recombinant DNA,DNA Proteins, Recombinant,Protein, Biosynthetic,Protein, Recombinant,Proteins, DNA Recombinant,Proteins, Recombinant,Recombinant DNA Proteins,Recombinant Proteins, DNA
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D016179 Granulocyte Colony-Stimulating Factor A glycoprotein of MW 25 kDa containing internal disulfide bonds. It induces the survival, proliferation, and differentiation of neutrophilic granulocyte precursor cells and functionally activates mature blood neutrophils. Among the family of colony-stimulating factors, G-CSF is the most potent inducer of terminal differentiation to granulocytes and macrophages of leukemic myeloid cell lines. Colony-Stimulating Factor, Granulocyte,G-CSF,Myeloid Growth Factor,Colony Stimulating Factor, Granulocyte,Factor, Granulocyte Colony-Stimulating,Factor, Myeloid Growth,Granulocyte Colony Stimulating Factor,Growth Factor, Myeloid
D018366 Vasculitis, Leukocytoclastic, Cutaneous Disorder characterized by a vasculitic syndrome associated with exposure to an antigen such as a drug, infectious agent, or other foreign or endogenous substance. Its pathophysiology includes immune complex deposition and a wide range of skin lesions. Hypersensitivity or allergy is present in some but not all cases. Angiitis, Hypersensitivity,Cutaneous Leukocytoclastic Vasculitis,Hypersensitivity Angiitis,Hypersensitivity Vasculitis,Vasculitis, Hypersensitivity,Allergic Cutaneous Angiitis,Allergic Cutaneous Vasculitis,Angiitis, Allergic Cutaneous,Cutaneous Allergic Vasculitis,Cutaneous Leukocytoclastic Angiitis,Vasculitis, Allergic Cutaneous,Allergic Cutaneous Angiitides,Allergic Cutaneous Vasculitides,Allergic Vasculitides, Cutaneous,Allergic Vasculitis, Cutaneous,Angiitides, Allergic Cutaneous,Angiitides, Cutaneous Leukocytoclastic,Angiitides, Hypersensitivity,Angiitis, Cutaneous Leukocytoclastic,Cutaneous Allergic Vasculitides,Cutaneous Angiitides, Allergic,Cutaneous Angiitis, Allergic,Cutaneous Leukocytoclastic Angiitides,Cutaneous Leukocytoclastic Vasculitides,Cutaneous Vasculitides, Allergic,Cutaneous Vasculitis, Allergic,Hypersensitivity Angiitides,Hypersensitivity Vasculitides,Leukocytoclastic Angiitides, Cutaneous,Leukocytoclastic Angiitis, Cutaneous,Leukocytoclastic Vasculitides, Cutaneous,Leukocytoclastic Vasculitis, Cutaneous,Vasculitides, Allergic Cutaneous,Vasculitides, Cutaneous Allergic,Vasculitides, Cutaneous Leukocytoclastic,Vasculitides, Hypersensitivity,Vasculitis, Cutaneous Allergic,Vasculitis, Cutaneous Leukocytoclastic
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