FACIAL ANGIOEDEMA ASSOCIATED WITH GRANULOCYTE-COLONY-STIMULATING FACTOR (G-CSF) TREATMENT

Background: Granulocyte colony-stimulating factor (C-CSF) is widely us ed to treat chemo- or radiotherapy-induced neutropenia and is also eff ective in the treatment of severe oral mucositis induced by chemothera py. With the common use of G-CSF the description of rare or new side e ffects becomes more important. Case Report: The 44-year-old male patie nt suffered from an inoperable carcinoma of the nasopharynx and underw ent a combined radio-chemotherapy consisting of paclitaxel weekly and irradiation with 70 Gy over 7 weeks. During the course of treatment, h e developed a severe oral mucositis. Since conventional therapy of muc ositis did not alleviate the symptoms, he was treated with G-CSF. With in 18 h after the subcutaneous administration of G-CSF he developed a severe facial angioedema. Within 3 days the patient recovered spontane ously from the angioedema, Because the relationship of the symptoms an d the G-CSF treatment was not clearly evident. a second dose of G-CSF was given 14 h after the subcutaneous injection of the same dose of G- CSF. the patient developed the identical symptoms of angioedema. Concl usion: Facial angioedema is a rare but important side effect after G-C SF treatment. A possible role of paclitaxel or radiation therapy in th e pathogenesis of this side effect cannot be ruled out.