Aortitis and aortic dissection after administration of pegfilgrastim during adjuvant chemotherapy for early breast cancer

A 70 year-old woman on adjuvant chemotherapy for breast cancer developed acute aortitis after receiving pegfilgrastim. 12 days after pegfilgrastim administration, she presented to our hospital with fever and shoulder pain. White blood cell count and C-reactive protein were elevated. As the computed tomography scan revealed thickening of the walls of the aortic arch and surrounding arteries, we suspected granulocyte colony-stimulating factor-related aortitis. Although steroid treatment administered once improved the general condition, her symptoms and C-reactive protein worsened again. On increasing the steroid dose, her general condition recovered rapidly. On day 85, Stanford type A aortic dissection was incidentally detected by a follow-up computed tomography scan. Physicians should recognize these adverse events of filgrastim.