VASCULITIS COMPLICATING GRANULOCYTE-COLONY-STIMULATING FACTOR TREATMENT OF LEUKOPENIA AND INFECTION IN FELTYS-SYNDROME

Recombinant myeloid growth factors have been increasingly used in recent years to combat induced and disease associated neutropenia. Their application in the management of Felty's syndrome with intercurrent infection has raised concern that resultant neutrophilia and activation of a diverse array of polymorphonuclear cell functions may have an adverse effect on the rheumatoid disease process. We describe a patient with Felty's syndrome receiving short term treatment with recombinant human granulocyte colony stimulating factor (GCSF), who then developed acute renal failure in conjunction with leukocytoclastic vasculitis and presumptive gout. We address the issue of ''adding fuel to the fire'' and review reported implications of GCSF in induction of vasculitis.