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Granulocyte-Macrophage Colony-Stimulating Factor and Vasculitis
- Robert Dreicer, MD, MS;
- Joan H. Schiller, MD; and
- Paul P. Carbone, MD
Excerpt
To the Editor: Recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF) is now being widely used in clinical trials. Reported toxic effects include fever, nausea and vomiting, bone pain, and fluid retention (1, 2). We report a case of exacerbated vasculitis in a patient with small-cell lung cancer who presented with a paraneoplastic vasculitis. The patient was treated with chemotherapy and rGM-CSF.
A 52-year-old man presented with cough, arthralgia, myalgia, and a rash on his thighs. A skin biopsy specimen showed leukocytoclastic vasculitis. Urinalysis was positive for occult blood and 1+ protein; serum creatinine was 88.4 µmol/L (1.0 mg/dL); Wintrobe sedimentation rate was
